Left upper lobectomy for a large incidental simple arteriovenous malformation

Abstract

We present an incidental finding of a large left upper lobe diffuse pulmonary arteriovenous malformation (PAVM) presenting with cyanosis, exertional shortness of breath, polycythemia, and low peripheral oxygen saturation. PAVMs are mostly diagnosed in symptomatic patients with therapeutic embolization as the first choice of therapy. This young woman had no symptoms but showed signs of hypoxemia, and further investigation revealed a huge central left upper lobe PAVM. A successful upper lobectomy resulted in a quick recovery and immediate return to normal peripheral oxygen saturation levels with no further comorbidity or recurrence during 3 years of current follow-up.

Keywords: Arteriovenous malformation; hypoxemia; lobectomy; polycythemia; thoracotomy.

Figure 1.

Computed tomography scan of the chest showing left upper lobe pulmonary arteriovenous malformation with feeding and draining vessels.