Rare Case of Large Arteriovenous Malformations Arising after a Parotid Tumour Excision

Arteriovenous Malformations (AVMs) of the head and neck are uncommon vascular anomalies characterised by high-flow shunting between arteries and veins without an intervening capillary bed. Among these, AVMs involving the parotid region are exceedingly rare and are often misdiagnosed or mistaken for more common salivary gland tumours. Their presentation may vary from painless swelling to disfiguring facial masses with the potential for life-threatening bleeding. Accurate diagnosis typically requires advanced imaging such as contrast-enhanced Computed Tomography (CT) or Digital Subtraction Angiography (DSA), as clinical signs may be subtle or absent. Management of craniofacial AVMs remains challenging due to complex vascular anatomy, the potential for recurrence, and the risks associated with surgical or endovascular interventions. A multidisciplinary approach involving interventional radiology, surgery, and supportive specialties is essential for optimal outcomes. This report highlights the diagnostic and therapeutic complexities of a large facial AVM discovered in an adult decades after parotid surgery, emphasising the importance of considering vascular anomalies in the differential diagnosis of longstanding facial swellings. The case reinforces the need for early recognition and careful planning in managing such lesions to reduce morbidity and improve prognosis. Given their rarity, each case contributes valuable insights to the evolving understanding and management of parotid and craniofacial AVMs.