Contemporary Diagnosis and Management of a Uterine Arteriovenous Malformation

BACKGROUND: Uterine arteriovenous malformations (AVMs) are extremely rare and can result in severe complications. Experience with diagnosis and management of these vascular malformations is very limited. CASE: We report on a patient with a history of nonmetastatic gestational trophoblastic disease. The patient developed a concomitant 4.4-cm intrauterine mass, suggestive of a molar pregnancy, during her second pregnancy. Despite suction and sharp curettage, the mass and menorrhagia persisted. After complex diagnostic imaging, the diagnosis of a uterine AVM was made. Subsequently, the patient underwent uterine arterial embolization and laparoscopic surgery to resect the mass. CONCLUSION: Because uterine AVMs are infrequently encountered, they initially may not be included in the differential diagnosis. The use of contemporary imaging, interventional radiology, and surgery can optimize patient outcome.