Abstract

A case of arteriovenous malformation of the right buccal region was reported.The patient was a 46 year-old male who complained of recurrent right nose bleeding of 3 months' duration and a mass in his right cheek.The mass was walnut-sized when he first noticed at the age of 36. It grew progressively to be a fist-size at the age of 41. Then, he was treated by radiotherapy at a certain institution. The mass was not increased in size but pulsations became markedly palpable after the treatment.On examination, a fist-sized pulsating mass was noted in his right cheek. The vascular dilatations were found on the right nasal and oral mucosa. Examination of the blood showed the marked anemia; Hb: 4.9g/dl, Ht: 16.4%. Carotid arteriogram revealed a vascular malformation of the buccal region. The dilated and torturous maxillary artery was diagnosed as a main component of the malformation. The right internal carotid artery, the left facial and maxillary arteries also gave blood supplies to the lesion in some extent.After the ligations of the right external carotid artery and left maxillary artery, the mass was resected. Histopathological diagnosis was arteriovenous malformation.No recurrence of symptom has been noted on 1 year follow-up.It is our impression that bilateral carotid arteriograms are essentially important for the surgical treatment because the malformation has many complicated collateral vessels.The diagnosis and treatment for arteriovenous malformations of the head and neck are briefly discussed.

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