Contemporary diagnosis and management of a uterine arteriovenous malformation.
BACKGROUND
Uterine arteriovenous malformations (AVMs) are extremely rare and can result in severe complications. Experience with diagnosis and management of these vascular malformations is very limited.


METHODS
We report on a patient with a history of nonmetastatic gestational trophoblastic disease. The patient developed a concomitant 4.4-cm intrauterine mass, suggestive of a molar pregnancy, during her second pregnancy. Despite suction and sharp curettage, the mass and menorrhagia persisted. After complex diagnostic imaging, the diagnosis of a uterine AVM was made. Subsequently, the patient underwent uterine arterial embolization and laparoscopic surgery to resect the mass.


CONCLUSIONS
Because uterine AVMs are infrequently encountered, they initially may not be included in the differential diagnosis. The use of contemporary imaging, interventional radiology, and surgery can optimize patient outcome.
Brown
John V
JV
Gynecologic Oncology Associates, Hoag Memorial Hospital Cancer Center, Hoag Hospital, Department of Maternal Fetal Medicine, Newport Beach, CA 92663, USA.
Asrat
Tamerou
T
Epstein
Howard D
HD
Oglevie
Steven
S
Goldstein
Bram H
BH
D000328:Adult; D001165:Arteriovenous Malformations / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D004621:Embolization, Therapeutic; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000150:complications; D006801:Humans; D007045:Hysterectomy, Vaginal; D010535:Laparoscopy; D018810:Magnetic Resonance Angiography; D011247:Pregnancy; D014599:Uterus / Q000098:blood supply* / Q000473:pathology