Operative Management of a Complicated Intercostal Arteriovenous Malformation in a Pediatric Patient: A case report
Abstract Arteriovenous malformations (AVMs) are rare lesions that may mimic giant hemangiomas. The most common location is the head and neck region, although very few reports of thoracic AVMs have been described. These lesions grow through childhood and adulthood and can lead to serious complications, such as tissue ischemia, ulceration, and bleeding. Magnetic Resonance Imaging (MRI) and angiography (MRA) are useful to assess extent of lesion. Treatment most commonly consists of embolization alone or in combination with surgical excision. In this report, we present a 7-year-old girl with a giant intercostal AVM of the right chest wall, including rib cage and intercostal spaces with overlying muscle involvement. The treatment approach was embolization followed by surgical resection and reconstruction of the chest wall. There were no complications in the postoperative period and the patient was discharged with minimal compensatory scoliosis and no functional impairment. Highlights Intercostal AVMs are lesions that grow throughout life that tend to be destructive and require surgical intervention. Hemangiomas are vascular lesions that are present at birth and involute in the first decade of life. Successful management of intercostal AVM can be achieved by embolization, surgical excision and reconstruction of chest wall.
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