High-flow arteriovenous malformation of the shoulder
Enlarging mass on the lateral aspect of the right shoulder.
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The palpable lump overlying the right shoulder corresponds to a mass containing serpiginous, dilated and tortuous vessels with flow voids in the deltoid muscle, measuring approximatley 10.0 x 7.7 x 4.4 cm.
This is fed from from the subclavian/axillary artery and drains into the axillary vein.
Arteriovenous malformations (AVMs) represent an abnormal leash of vessels through which there is arteriovenous shunting. They can occur anywhere in the body, with the shoulder being one of the less common sites.
AVMs may be slow or high flow, as in this case. This is a real whooper of a high flow AVM in the deltoid muscle, with arterial supply from a very generously proportioned subclavian artery.
Interventional radiologists play a key role in treatment, through the embolization of appropriate cases.