Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020:76:394-398.
doi: 10.1016/j.ijscr.2020.10.011. Epub 2020 Oct 7.

A rare case of a intraosseous arteriovenous malformation of the temporomandibular joint and mandible - Case report and literature review

Kristian K Blackhall  1 , Eugenie Ling  2 , Jayanth Kunjur  2
Affiliations
Case Reports

A rare case of a intraosseous arteriovenous malformation of the temporomandibular joint and mandible - Case report and literature review

Kristian K Blackhall et al. Int J Surg Case Rep. 2020.

Abstract

Introduction: This case report looks at a 47 year-old patient, presenting with a rapid onset mass of the left face. This report examines the case, the investigations undertaken, its management and undertakes a literature review of this uncommon condition and rare presentation.

Presentation of case: This patient had experienced functional deterioration, restriction and an evident swelling of the left face. Having identified the mass to arise from the mandibular condyle, an incisional biopsy was undertaken. The histology was suggestive of an arteriovenous malformation. Surgery was undertaken to excise the entire left mandibular condyle along with the lesion and then replace the temporomandibular joint with a custom made prosthesis.

Discussion: Arteriovenous malformations, or Haemiangiomas, can arise in any part of the body and can often grow over time. Although benign, lesions can be locally invasive and distort anatomy, resulting in functional issues. Their risk for hemorrhage and potentially significant blood losses is also a risk factor in their presence. Rarely arteriovenous malformations can occur in hard tissue, as in this case distorting and obliterating the temporomandibular joint. One's only recourse is to remove and eliminate the lesion, however in cases such as this significant morbidity could ensue due to functional deficit. Hence consideration must be given to reconstruction.

Conclusion: Having excised the mass and reconstructed the temporomandibular joint with a titanium prosthesis, the patient experienced a good recovery with a return to normality.

Keywords: Arteriovenous malformation; Case report; Maxillofacial; Temporomandibular joint replacement.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
CT Imaging demonstrating the lesion of the left temporomandibular joint and mandible. (a) - Axial plane, (b) - Sagittal plane, (c) - Coronal plane.
Fig. 2
Fig. 2
Histology slides obtained. (a) - Demonstrating capillary structures [2.5× power], (b) - Demonstrating larger vascular structures [2.5× power].
Fig. 3
Fig. 3
3D planning render for the left temporomandibular joint. (a)+(b) - Preoperative view demonstrating AVM extent [purple] and planned resection [red], (c)+(d) - Postoperative titanium prosthesis position.
See this image and copyright information in PMC

References

    1. Rosen R.J., Nassiri N., Drury J.E. Interventional management of high-flow vascular malformations. Tech. Vasc. Interv. Radiol. 2013;16(March (1)):22–38. doi: 10.1053/j.tvir.2013.01.004. - DOI - PubMed
    1. Fan X.D., Su L.X., Zheng J.W., Zheng L.Z., Zhang Z.Y. Ethanol embolization of arteriovenous malformations of the mandible. AJNR Am. J. Neuroradiol. 2009;30(March (6)):1178–1183. doi: 10.3174/ajnr.A1539. - DOI - PMC - PubMed
    1. Bayrak-Toydemir P., Stevenson D. In: Capillary Malformation-Arteriovenous Malformation Syndrome. Adam M.P., Ardinger H.H., Pagon R.A., editors. University of Washington, Seattle; Seattle (WA): 2011. pp. 1993–2020.https://www.ncbi.nlm.nih.gov/books/NBK52764/ Feb 22 [Updated 2019 Sep 12], GeneReviews® [Internet], Available from. - PubMed
    1. Fan X., Qiu W., Zhang Z., Mao Q. Comparative study of clinical manifestation, plain-film radiography, and computed tomographic scan in arteriovenous malformations of the jaws. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontol. 2002;94(October (4)):503–509. doi: 10.1067/moe.2002.126910. - DOI - PubMed
    1. ISSVA classification for vascular anomalies. [Internet]. International Society for the Study of Vascular Anomalies, May 2018 [cited 31 Aug 2020]. Available from: https://www.issva.org/UserFiles/file/ISSVA-Classification-2018.pdf.

Publication types