Plastic, Reconstructive & Burns Surgery, All India Institute of Medical Sciences, New Delhi, India.
Plastic, Reconstructive & Burns Surgery, All India Institute of Medical Sciences, New Delhi, India
BMJ Case Rep. 2022 Apr 20;15(4):e245545. doi: 10.1136/bcr-2021-245545.
A 54-year-old woman who had previously undergone total excision of an arteriovenous malformation (AVM) of lower lip and chin along with pedicled medial arm flap reconstruction, presented with recurrence of swelling in the same region. The patient reported progressive difficulty in feeding, talking and constant aching pain besides aesthetic concerns. On evaluation, recurrence of AVM with invasion into the flap substance was identified. We performed debulking surgery, which resulted in a considerable reduction in pain and improved lower lip functioning and aesthetic appeal of the face. This case is unique due to the rare presentation of an AVM invading the normal flap tissue. Such a finding has never been reported before for a pedicled flap, along with details of the histopathology and imaging description. There are lacunae in the understanding of the progression of vascular malformations and this additional information will add to the existing literature on AVM.
一位 54 岁的女性，先前曾接受过下唇和颏部动静脉畸形（AVM）的全切除手术，并进行带蒂内臂皮瓣重建，现同一部位出现肿胀复发。患者报告说，除了美观问题外，还出现了进食、说话困难以及持续的酸痛。评估时，发现 AVM 复发并侵犯了皮瓣组织。我们进行了去瘤手术，这导致疼痛明显减轻，下唇功能和面部美观得到改善。由于 AVM 侵犯正常皮瓣组织，这种罕见的表现使该病例具有独特性。这种发现以前从未在带蒂皮瓣中报道过，同时还详细描述了组织病理学和影像学。目前对血管畸形进展的认识还存在空白，这将为 AVM 的现有文献增添新的信息。
