[A case of congenital AVM in temporoparietal muscle]

A rare case with coexistent congenital scalp AVM in the temporoparietal muscle and a saccular aneurysm of the main feeder is presented. A 47-year-old female was admitted with the complaint of a right gradually expanding and painful pre-auricular mass. Physical examination showed a round, tender and compressible tumor measuring 3 x 3 cm in the right pre-auricular region, and there was bruit on the mass. Pre- and Post-contrast CT scans showed a slightly enhanced extracranial mass in the right temporal subcutaneous region. MR imaging showed a flow void mass both on T1 and T2 weighted images. Selective external carotid angiogram revealed multiple feeders deriving from the superficial temporal artery (STA) and the abnormal vascular networks. And also the saccular aneurysm was detected in the main feeder of the STA. Under a diagnosis of scalp AVM, it was totally removed with the temporoparietal muscle, and the aneurysmal neck was ligated. Histopathological examination revealed AVM. She was discharged on the 17th postoperative day with no deficits. Based on our experience and a review of the literature, the treatment of choice is embolization for scalp AVM localized in the skin alone and surgical total removal for AVM embedded in the muscle.