Intramuscular Arteriovenous Malformation of the Gluteus Maximus Muscle

Abstract

Extracranial arteriovenous malformations (AVMs) are far less common than intracranial AVMs. AVMs mostly involve the skin, subcutaneous tissue and even the musculoskeletal system extensively. The goal of treatment is to control the AVM, using tumor debulking or arterial embolization; complete tumor excision is usually not possible and the local recurrence rate is high. Intramuscular AVMs are rare and these lesions can be curable with complete surgical resection. We present a case of a rare intramuscular AVM of the right gluteus maximus muscle in a 33-year-old man. The AVM had undergone progressive enlargement and produced pulsation and pain. We performed selective embolization and radical excision of the AVM with removal of the entire muscle. There was no local recurrence of the AVM and the patient’s right hip extension and external rotation had recovered well at a 12-month follow-up. AVMs are extremely rare in skeletal muscle and less than 1% of vasoformative tumors throughout the body occur in such locations. The treatment of choice is a combination of selective embolization and radical excision to avoid recurrence. In fact, intramuscular AVMs are curable compared with those in other sites.