Outcomes for brain AVM surgery were not improved by ethylene-vinyl alcohol copolymer embolization. Preoperative embolization of high-grade AVMs with an ethylene-vinyl alcohol copolymer did not prevent those hemorrhagic complications which embolization is hypothesized to prevent based on theoretical speculations but not demonstrated in practice.

The risk of recurrence after AVM resection is significant for young patients with deep venous drainage.

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An elderly lady presented with a 2-year history of intermittent vaginal bleeding and later the development of a vulvovaginal mass. A core biopsy histology specimen from the mass and the left inguinal lymph node was suggestive of metastatic adenocarcinoma of breast origin. No breast lesion was detected on mammography, and axillary nodes were negative. The histopathologic features and the expression of GATA3, cytokeratin (CK)7, mammaglobin staining and estrogen and progesterone receptors led to a diagnosis of breast cancer originating from the ectopic mammary tissue in the vulva. Given the rarity of these lesions, and the lack of standard treatment guidelines, the management of the patient was extrapolated from the established breast cancer treatment guidelines. Radiotherapy and chemotherapy followed by hormone therapy with aromatase inhibitor were administered to this patient in the metastatic setting with good palliation.