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妊娠期下颌动静脉畸形

Mandibular arteriovenous malformation in pregnancy.

作者信息

McMahon M J, Hansen W F, O'Meara A T

机构信息

University of North Carolina at Chapel Hill, School of Medicine, Department of Obstetrics and Gynecology, 27599-7570, USA.

出版信息

Am J Perinatol. 1997 Nov;14(10):619-21. doi: 10.1055/s-2008-1040765.

Abstract

Benign vascular lesions, such as hemangiomas of childhood, arteriovenous malformations (AVMs) and venous malformations, are uncommon and have been found in a variety of organs throughout the body. Vascular lesions of bone are found most often in the vertebral column. Vascular tumors of the mandible are rare. We report a case of a mandibular AVM found in a pregnant woman at 35 weeks' gestation. A pregnant woman presented at 35 weeks' gestation with right-sided jaw pain and was found to have a pulsatile mass on the internal surface of the right mandible in the area of the premolars. Profuse bleeding of the lesion required emergent selective arterial embolization of a vascular tumor of the mandible, which resulted in successful occlusion of the vessels. Uncomplicated vaginal delivery followed induction of labor. Excision and reconstructive surgery occurred 1 week postembolization. Pathology confirmed an AVM. Mandibular AVMs are rare vascular tumors that, when correctly diagnosed, can be successfully managed during pregnancy. Whether or not vascular or hormonal changes associated with pregnancy can exacerbate a preexisting AVM is debatable.

摘要

良性血管病变,如儿童血管瘤、动静脉畸形(AVM)和静脉畸形,并不常见,已在全身各种器官中被发现。骨血管病变最常发生在脊柱。下颌骨血管肿瘤罕见。我们报告一例在妊娠35周时发现的下颌骨AVM病例。一名孕妇在妊娠35周时出现右侧颌部疼痛,在右侧下颌骨前磨牙区域的内表面发现有一个搏动性肿块。病变大量出血,需要紧急对下颌骨血管肿瘤进行选择性动脉栓塞,这导致血管成功闭塞。引产顺利经阴道分娩。栓塞术后1周进行切除和重建手术。病理证实为AVM。下颌骨AVM是罕见的血管肿瘤,正确诊断后在孕期可成功治疗。与妊娠相关的血管或激素变化是否会加重已有的AVM仍有争议。

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