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Where’s the Stethoscope?: An Orbital AVM Case Report
Thomas Shane, M.D.
Contributing Editor
Case History:
A 20 year old male presents to the oculoplastics service with a chief complaint of a right brow mass. The patient states that the mass is painless and has been slowly enlarging over the previous two years. He denies any past ocular history or trauma.
Past medical history is positive for tonsillectomy. The patient takes no medicines. Family and social history are non-contributory. Review of systems is negative.
On clinical examination, the patient is alert, and oriented. His visual acuity is 20/25 in both eyes. Examination of the right brow reveals a soft, non-tender mass approximately 2 cm x 1 cm in dimension (Figure 1). The mass is pink and pulsatile in nature, with an audible bruit upon auscultation. There is no globe displacement or proptosis. The remainder of the ocular exam is within normal limits.
Ultrasound of the mass shows an irregularly shaped network of tubular, low-reflective, high-flow lesions filling the anterior superotemporal orbit (Figure 2). The lesions do not enlarge on valsalva. MRI of the mass demonstrates prominent vascular flow voids (Figure 3).
Diagnosis: Orbital Arteriovenous Malformation (AVM)
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I am sorry,,, I don't have much to say. Seems like I am getting a cold.
So good bye... I'll talk at you soon.
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