Uterine arteriovenous malformation (AVM) is a rare vascular condition. It is a dilatation of the intervillous space deep inside the myometrium, allowing a direct flow from the arterial system towards the venous system, without participation of capillary vessels. Such condition represents about 1–2% of all genital and intraperitoneal hemorrhages¹.

In this case, on a routine exam, the patient had no symptoms related and a previous story of a cesarean section. Unfortunately, we had no past exams to confirm a probably acquired or congenital uterine AVM.

In most cases, such malformation is acquired, with a great variety of causes, including gestational trophoblastic disease (GTD), pelvic trauma, surgical procedures (cesarean section, curettage), cervical or endometrial carcinoma, infection and exposure to diethylstilbestrol. The association of the clinical history with imaging findings is useful in the differentiation between congenital and acquired presentations¹.

Differential diagnoses with similar sonographic findings include GTD and other hypervascular lesions such as retained conception products and abnormal placentation¹.