Cao WY, Li JP, Guo P, Song LX. Ectopic recurrence following treatment of arteriovenous malformations in an adult: A case report and review of literature. World J Radiol 2024; 16(10): 537-544 [PMID: 39494139 DOI: 10.4329/wjr.v16.i10.537]
Corresponding Author of This Article
Jin-Ping Li, MD, Chief Physician, Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing 100020, China. ljp6855@aliyun.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Oct 28, 2024; 16(10): 537-544 Published online Oct 28, 2024. doi: 10.4329/wjr.v16.i10.537
Ectopic recurrence following treatment of arteriovenous malformations in an adult: A case report and review of literature
Wen-Yu Cao, Jin-Ping Li, Peng Guo, Ling-Xie Song
Wen-Yu Cao, Jin-Ping Li, Peng Guo, Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
Ling-Xie Song, Department of Pathology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
Author contributions: Cao WY is the first author who performed the literature search and wrote the paper; Li JP provided the medical records; Guo P revised the paper; and Song LX provided the pathological data. All the authors reviewed the results and approved the final version of the manuscript.
Supported byBeijing Municipal Science and Technology Project, No. Z201100005520095.
Informed consent statement: The informed consent form has been signed.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Ping Li, MD, Chief Physician, Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing 100020, China. ljp6855@aliyun.com
Received: February 3, 2024 Revised: September 11, 2024 Accepted: September 23, 2024 Published online: October 28, 2024 Processing time: 267 Days and 18.3 Hours
Abstract
BACKGROUND
Digital subtraction angiography (DSA), the gold standard for the diagnosis of intracranial arteriovenous malformations (AVMs), can show clean nidus resection, leading to a perceived cure. Most cases of intracranial AVM recurrence have been reported in pediatric patients. The conventional understanding indicates that AVMs arise when abnormal blood vessels develop between the fourth and eighth weeks of embryonic development, which coincides with the typical period of blood vessel formation in the brain. As such, recurrent ectopic AVM are rare in adults.
CASE SUMMARY
Herein, we present the case of a 31-year-old adult with a history of an intracranial AVM originally diagnosed with a symptomatic de novo cerebellar AVM formation. Recurrence was observed five years following angiographically-confirmed excision of the initial AVM. DSA performed prior to initial AVM resection indicated no cerebellar abnormalities. Moreover, the recurrent arteries exhibited differences in arteries and draining veins. In addition to reporting this case, we analyzed six previously-reported adult patients with similar ectopic recurrent AVMs. These cases are summarized to review and explore the potential causes of ectopic AVM recurrence in adults, which increase the likelihood of acquired AVM.
CONCLUSION
The clinical course of the reported patients demonstrated the possibility of ectopic AVM recurrence in adults. The median time between the diagnosis of the initial AVM and the occurrence of ectopic recurrent AVM in adults was 11 years (range: 5–20 years). Magnetic resonance imaging follow-up for more than 10 years may be required in adult AVM-treated patients.
Core Tip: This study highlights an exceptionally rare case of ectopic recurrent intracranial arteriovenous malformation (AVM) in a 31-year-old adult, diagnosed five years following initial AVM resection. this de novo cerebellar AVM demonstrated arterial and venous configurations distinct from typical pediatric cases. Reviewing six similar adult cases, this study explored the potential causes of such rare recurrences. This experience suggests that prolonged magnetic resonance imaging follow-up beyond 10 years may be required to detect new AVMs in previously treated patients.
