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Arteriovenous malformation of the soft tissues

Case contributed by Khalid Alhusseiny
Diagnosis certain

Presentation

Chronic localized swelling (mass) at the right forearm.

Patient Data

Age: 55 years
Gender: Female

A deep subcutaneous fusiform lesion is seen at the middle 1/3 of the extensor aspect of the right forearm. It is predominantly solid and hypoechoic with small cystic spaces. It is seen along the course of a venous tributary of the right basilic vein which shows near-total thrombosis along its course in the forearm.

The lesion shows multiple areas of internal vascularity with mixed arterial and venous flow with high diastolic flow. An arterial feeder is seen related to the deep aspect of the lesion.

The arrow on the image points to an area of possible calcification.

Case Discussion

These sonographic findings are suggestive of arteriovenous malformation.

The lesion was surgically removed after ligation of the feeding vessels and histopathology confirmed the diagnosis of arteriovenous malformation.

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