Congenital arteriovenous malformation of the chest wall

Case contributed by Huy Sruy

Presentation

Palpable mass without pain at the anterior of left chest, slightly bigger day by day.

Patient Data

Age: 20 years
Gender: Female

PA chest radiograph

x_ray

A homogeneous oval opacity projects over the lateral arc of 3rd-8th left ribs with a inner well-defined border and an ill-defined outer margin (the incomplete border sign) consistent with an extra-pulmonary mass.

CT chest angiography

ct

The study reveals the left pleural based mass at the lateral aspect of left 3rd-6th intercostal spaces. Multiple serpiginous vessels are detected within this lesion. There are feeding arteries originating from an intercostal artery and thoracodorsal branch of axillary artery. Two draining veins along the left lateral chest wall to drain to the axillary vein.

No pulmonary mass or nodule are seen.

No pleural effusion is seen.

No cardiomegaly or pericardial effusion are detected.

No mediastinal lymphadenopathy.

Impression: AVF of the chest wall is the likely diagnosis.

Case Discussion

An arteriovenous malformation located on the chest wall is a rare lesion. Life threatening bleeding from the vascular malformation is a major complication for affected patients.

Special thanks to prof. Chutcharn. Body Interventional Radiologist at Phramongkutklao Hospital.

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