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Arteriovenous malformation in pancreas mimicking hypervascular tumor
Keisuke Ishigami1, Tomoya Sakuma2, Masato Saito3
1Department of Gastroenterology and Hepatology Sapporo Medical University School of Medicine Sapporo Japan.
Abstract:
Arteriovenous malformation (AVM) is defined as a disease that causes blood flow abnormality due to anastomoses of the arteries and veins. AVM can occur in any gastrointestinal tract, but pancreatic AVM (P-AVM) is very rare. Previous reports demonstrated that contrast-enhanced CT (CECT) typically showed abnormal vascular network in pancreas. We present a 58-year old man with a history of acute pancreatitis. He was referred to our hospital for examination of pancreatic mass. CECT showed a round-shaped hypervascular lesion with a diameter of 8 mm in the head of the pancreas. Selective angiography showed vascular network and early visualization of superior mesenteric vein. We finally diagnosed this case as P-AVM. He underwent duodenum preserving pancreatic head resection. Histological findings confirmed the preoperative diagnosis of P-AVM.
Insights
Pancreatic arteriovenous malformation (P-AVM) is a rare vascular anomaly. This case highlights diagnosis via contrast-enhanced CT and angiography, followed by surgical resection of a P-AVM.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Radiology
Background:
- Arteriovenous malformation (AVM) involves abnormal connections between arteries and veins.
- Pancreatic AVM (P-AVM) is an exceptionally rare form of AVM within the gastrointestinal tract.
- Previous studies indicate contrast-enhanced CT (CECT) as a key diagnostic tool for pancreatic AVM.
Purpose of the Study:
- To report a rare case of pancreatic arteriovenous malformation (P-AVM).
- To illustrate the diagnostic process for P-AVM using advanced imaging techniques.
- To document the successful surgical management of a P-AVM.
Main Methods:
- A 58-year-old male patient presented with symptoms suggestive of a pancreatic mass.
- Diagnostic imaging included contrast-enhanced CT (CECT) and selective angiography.
- The patient underwent a duodenum-preserving pancreatic head resection.
Main Results:
- CECT revealed an 8 mm hypervascular lesion in the pancreatic head.
- Selective angiography demonstrated an abnormal vascular network and early superior mesenteric vein visualization.
- Histopathological examination confirmed the diagnosis of P-AVM.
Conclusions:
- P-AVM is a rare but significant vascular abnormality of the pancreas.
- Multimodal imaging, including CECT and angiography, is crucial for accurate diagnosis.
- Surgical resection, such as duodenum-preserving pancreatic head resection, can be an effective treatment for P-AVM.
