Retroauricular Extracranial Avm – Case Management And Literature Review

Introduction: Extracranial arteriovenous malformations (AVMs) are rare but challenging vascular anomalies characterized by direct arteriovenous connections that bypass the capillary network, leading to progressive lesion growth, hemorrhage, and functional impairment. The management of these lesions remains complex due to high recurrence rates and the need for multidisciplinary therapeutic approaches. Case Presentation: We report the case of a 51-year-old female presenting with a left retroauricular pulsatile mass, headaches, and audible bruits. Magnetic resonance imaging (MRI) revealed an extracranial AVM with a 17 × 30 mm nidus. Surgical resection was performed following preoperative evaluation, involving meticulous dissection, selective vascular control, and complete excision of the malformation. The patient had a favorable postoperative course, with no neurological deficits and early hospital discharge. Discussion: Extracranial AVMs pose significant diagnostic and therapeutic challenges. While embolization serves as an adjunctive measure to reduce intraoperative bleeding, complete surgical resection remains the definitive treatment. However, lesion recurrence is common due to residual microscopic arteriovenous shunts and neovascularization. Advances in molecular pathology have identified key angiogenic pathways involved in AVM progression, opening new avenues for targeted therapies. Conclusion: This case highlights the importance of early diagnosis, comprehensive imaging assessment, and individualized surgical planning for optimal patient outcomes. Multimodal strategies integrating endovascular techniques and surgical resection remain crucial in managing extracranial AVMs. Long-term follow-up is essential to detect potential recurrence and guide future therapeutic decisions.