Resection and immediate reconstruction of a pediatric vascular malformation in the mandible: case report

Arteriovenous malformations (AVMs) within the mandible are rare and potentially life-threatening conditions that can pose a therapeutic dilemma. We present the case of a child with significant spontaneous gingival bleeding, radiographic evidence of a space-occupying lesion of the mandible, and delayed diagnosis and treatment because of parental reluctance to accept invasive treatment. Imaging studies and intravascular embolization with coils limited, but did not stop blood flow to this lesion. Resection of the mandible was the definitive treatment. The AVM was removed from the resected segment and the bone was replaced as a free graft, thereby avoiding a second site morbidity. Two years after surgery the replaced segment was well consolidated with moderate vertical resorption-remodeling.