Congenital giant arteriovenous malformation in a 31-year-old male

In this case presentation we report the history of a 31-year-old male suffering from a congenital giant arteriovenous malformation (AVM) of the neck and the right chest wall over the course of 12 years. This vascular tumor was fed by dilated arteries, branches of the right external carotid, and both subclavian arteries. The first therapeutic procedure was an isolated ligation of the draining arteries, which was not successful as angiography showed two years later. As the patient rejected any further therapy, the enormous growing tumor was again treated 9 years later. At this time an interdisciplinary management involving radiologists and surgeons was arranged. Superselective embolization preceding surgical radical tumor resection was performed. After a follow-up period of almost 1 year no further signs of progression were seen, except the postsurgical embolization of one collateral external carotid branch and a beginning skin necrosis which was to be expected. However, recently progression has become evident, but the patient has refused further treatment.