Gingival Bleeding of a High-Flow Mandibular Arteriovenous Malformation in a Child with 8-Year Follow-Up

Abstract

Intraosseous arteriovenous malformations (AVMs) in the head and neck region are uncommon. There are several types and they can have a wide range of clinical presentations. Depending on the blood flow through the AVM, the treatment may be challenging for the attending team and may lead to life-threatening hemorrhages. A clinical case report is presented. A 9-year-old girl, seen for gingival bleeding during oral hygiene, was found to have a high-flow AVM located within and around the mandible. Two-stage treatment consisted of intra-arterial embolization followed by intraoral injection of a sclerosing agent 8 weeks later. At the 8-year follow-up, imaging study showed no evidence of recurrent lesion inside or outside the bone. The final outcome is a correct occlusion with a symmetric facial result. This case shows that conservative treatment may be the first treatment option mostly in children. Arteriography and transcortical injection were enough to control the AVM.

Intraosseous Venous Malformation of the Zygomatic Bone: Comparison between Virtual Surgical Planning and Standard Surgery with Review of the Literature

“…Contemplating the range of therapeutic options for these types of injuries in the literature, multidisciplinary management is considered the gold standard [ 4 , 32 ]. Surveillance may be an option in asymptomatic cases [ 33 ].…”

Endodontic implications of a patient with arteriovenous malformation: a case report and literature review

“…1983, Ferrés‐Amat et al . 2015). They are grouped together because of the common embryological origin having a single endothelial cell lining (Mulliken & Glowacki 1982).…”

“…Vascular malformations are classified according to the vessel and amount of flow through the vessel as ‘high flow’ (fistulas, arteriovenous malformations and mixed malformations) and ‘low flow’ (capillary, venous, lymphatic malformations and mixed malformations) (Ferrés‐Amat et al . 2015). Amongst the various VM, arteriovenous malformations (AVMs) are the most dangerous due to their potentially fatal outcome.…”

“…These two are differentiated based on histopathological assessment (Cox et al 2014). Vascular malformations (VMs) are usually present since birth; however, the patient may be asymptomatic, and hence VM may remain unnoticed at that time (Ferr es-Amat et al 2015). The areas involved in VM are mostly the head and neck, but may also affect the skin, cranial cavity and other parts of the body (Finn et al 1983, Ferr es-Amat et al 2015.…”

“…Vascular malformations (VMs) are usually present since birth; however, the patient may be asymptomatic, and hence VM may remain unnoticed at that time (Ferr es-Amat et al 2015). The areas involved in VM are mostly the head and neck, but may also affect the skin, cranial cavity and other parts of the body (Finn et al 1983, Ferr es-Amat et al 2015. They are grouped together because of the common embryological origin having a single endothelial cell lining (Mulliken & Glowacki 1982).…”