Extensive bilateral arteriovenous malformations of the mandible successfully controlled by combined endovascular and transcutaneous angio-embolization: Case report and review of the literature

We report a unique case of extensive bilateral arteriovenous malformation (AVMs) in a child's mandible, discuss treatment options and review literature. A healthy 8 year-old girl presented with bright blood of unknown source found on her pillow. Three large AVMs involving the symphyseal region and bilateral mandibular bodies were found on angiography. Due to the extent of surgical resection required, the patient underwent a series of endovascular and transcutaneous angio-embolization. In cases of extensive intraosseous AVMs, serial embolization procedures can be successful in controlling episodes of hemorrhage and allow for bone remineralization. A multidisciplinary approach by otolaryngologists and neurointerventional radiologists can optimize the results.