Bronchial arteriovenous malformation with large aneurysm, resected by video-assisted thoracic surgery

Bronchial arteriovenous malformation with a large aneurysm appearing as a mass shadow in the right hilum on chest imaging was successfully extirpated thoracoscopically without any lung resection. Preoperative angiography showed tortuous, enlarged right bronchial arteries with an aneurysm connecting to the pulmonary artery, which could not be totally embolized via the transcatheter approach because of the length of the abnormal bronchial artery and possibility of embolotherapy-induced pulmonary infarction. Histological examination revealed defects of the media and internal elastic lamina of the resected bronchial arteries and aneurysm. The patient was free of hemoptysis and other airway symptoms 4 years after surgery.