Malformación arteriovenosa cervical supraclavicular con drenaje a la vena yugular izquierda en una mujer adulta: reporte de caso

Noelia Deyanira Choez-Abendaño; Yoselyn Isabel Choez-Abendaño; María Gabriela Jadán-Ayala; Dayanna Yamirle Eras-Palta

Authors

Choez-Abendaño Noelia Deyanira Médico General, Centro de Salud Tipo C. Puerto López, Ecuador. https://orcid.org/0009-0009-3576-3394
Choez-Abendaño Yoselyn Isabel Médico General, Consultorio Privado Integral. Ecuador. https://orcid.org/0000-0001-6676-0430
Jadán-Ayala María Gabriela Médico General, Hospital Básico de Paquisha. Ecuador. https://orcid.org/0009-0009-1688-0974
Eras-Palta Dayanna Yamirle Médico General. Loja, Ecuador. https://orcid.org/0009-0003-8316-6152

Keywords:

arteriovenous malformations; jugular veins; ultrasonography, Doppler, color; neck; case reports

Abstract

DOI: https://doi.org/10.46296/gt.v9i18.0410

Abstract

Introduction: extracranial arteriovenous malformations (AVMs) are rare high-flow vascular anomalies, most frequently located in the head and neck. Presentation in adulthood as a supraclavicular mass is unusual and may be mistaken for lymphadenopathy or other cervical lesions. Case presentation: a 62-year-old woman from Loja, Ecuador, presented with a painless left supraclavicular mass of nine months’ duration without progressive growth, and a three-month history of subjective right-sided weakness and right-hand resting tremor. Examination revealed a soft, mobile, non-pulsatile 2-cm mass; muscle strength was 5/5, with right patellar hyperreflexia. Color Doppler ultrasound showed a serpiginous anechoic structure measuring 4.18 × 0.66 cm with turbulent low-resistance flow, in continuity with the left jugular vein, suggestive of an AVM; the left carotid artery was normal, and an incidental right thyroid colloid cyst was found. Neck CT angiography was recommended to confirm the diagnosis and plan management. Conclusion: in an adult with a supraclavicular mass, color Doppler ultrasound is an accessible tool to recognize its vascular nature and guide angiographic work-up. Confirmation by CT angiography and multidisciplinary assessment are essential before management decisions, and concomitant neurological findings require independent investigation.

Keywords: arteriovenous malformations; jugular veins; ultrasonography, Doppler, color; neck; case reports.

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References

Wassef M, Blei F, Adams D, Alomari A, Baselga E, Berenstein A, et al. Vascular anomalies classification: recommendations from the International Society for the Study of Vascular Anomalies. Pediatrics. 2015;136(1):e203-14. https://doi.org/10.1542/peds.2014-3673

Tanoue S, Tanaka N, Koganemaru M, Kuhara A, Kugiyama T, Sawano M, et al. Head and neck arteriovenous malformations: clinical manifestations and endovascular treatments. Interv Radiol (Higashimatsuyama). 2023;8(2):23-35. https://doi.org/10.22575/interventionalradiology.2022-0009

Kohout MP, Hansen M, Pribaz JJ, Mulliken JB. Arteriovenous malformations of the head and neck: natural history and management. Plast Reconstr Surg. 1998;102(3):643-54. https://doi.org/10.1097/00006534-199809030-00006

Liu AS, Mulliken JB, Zurakowski D, Fishman SJ, Greene AK. Extracranial arteriovenous malformations: natural progression and recurrence after treatment. Plast Reconstr Surg. 2010;125(4):1185-94. https://doi.org/10.1097/PRS.0b013e3181d18070

Johnson CM, Navarro OM. Clinical and sonographic features of pediatric soft-tissue vascular anomalies part 2: vascular malformations. Pediatr Radiol. 2017;47(9):1196-208. https://doi.org/10.1007/s00247-017-3906-x

Mittal A, Anand R, Gauba R, Choudhury SR, Abbey P. A step-by-step sonographic approach to vascular anomalies in the pediatric population: a pictorial essay. Indian J Radiol Imaging. 2021;31(1):157-71. https://doi.org/10.1055/s-0041-1729486

Vrinceanu D, Dumitru M, Marinescu A, Dorobat B, Palade OD, Manole F, et al. New insights into cervicofacial vascular anomalies. J Clin Med. 2024;13(12):3515. https://doi.org/10.3390/jcm13123515

Malik MH, Jabal MS, Kobeissi H, Gupta R, Bilgin C, Brinjikji W. Embolization of arteriovenous malformations of head and neck: a systematic review. Interv Neuroradiol. 2025;31(6):852-8. https://doi.org/10.1177/15910199231219823

Putra AW, Indrasari SR, Herdini C, Yudistira D. Unveiling the myth of high recurrence rate of extracranial arteriovenous malformations of the head and neck: systematic review of case reports and case series. F1000Res. 2024;13:697. https://doi.org/10.12688/f1000research.147233.2

Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D; CARE Group. The CARE guidelines: consensus-based clinical case reporting guideline development. Glob Adv Health Med. 2013;2(5):38-43. https://doi.org/10.7453/gahmj.2013.008

Alkusayer MM, Alharbi AS, Aljabri NM, Al Saqer RM, Alhammad BN, Alahmadi RM. Internal jugular vein phlebectasia: a systematic review of therapeutic approaches in pediatrics. Int J Pediatr Otorhinolaryngol. 2023;175:111720. https://doi.org/10.1016/j.ijporl.2023.111720

Chew LS, Han JX, Ng YP, Ng HB. Surgical resection of carotid-jugular arteriovenous fistula after multiple failed embolisation. BMJ Case Rep. 2019;12(3):e228232. https://doi.org/10.1136/bcr-2018-228232