Arteriovenous Malformation Presenting as Symptomatic, Enlarging and Contrast-Enhancing Mass 12 Years After Being Treated with Embolization and Radiotherapy

Abstract

Background: Gross total resection of arteriovenous malformations (AVMs) of the central nervous system confirmed by formal angiography is accepted as a cure for patients. In some cases, this may not be possible. Even though in these cases other treatment modalities such as endovascular embolization and radiotherapy can be used, long-term follow-up is lacking in the literature.

Case description: Here we report a case of a 57-year-old woman with history of a right-sided parieto-occipital/periatrial AVM, initially treated with a combination of endovascular embolization and radiotherapy.

Conclusions: The patient subsequently presented (12 years later) with a symptomatic, enlarging, contrast-enhancing mass at the same location that was angiographically occult but ultimately proven to be an AVM on a background of reactive changes on pathology.

Keywords: AVM; Arteriovenous malformation; Avascular; Pathology.