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Background <p> Arteriovenous malformations (AVMs) are rare vascular anomalies and their intraosseous presentation in the mandible is exceptionally uncommon. Misdiagnosis can lead to catastrophic bleeding during routine dental procedures.</p> Purpose <p>This case report describes a rare instance of high-flow mandibular AVM mimicking a benign odontogenic lesion, underscoring the diagnostic challenges and the vital role of advanced imaging in timely intervention.</p> Result <p>A 22-year-old female presented with persistent swelling and pain in the lower left jaw one year following a traumatic extraction of the mandibular first molar. Clinical examination revealed a pulsatile swelling. Conventional radiography suggested a benign lesion; however, MRI with angiography confirmed a high-flow intraosseous AVM with arterial supply from the left buccal and facial arteries. Imaging findings, along with clinical features, led to the diagnosis of a high-flow mandibular AVM. Given the high risk of haemorrhage, surgical intervention in the form of Endovascular surgery with glue embolization using cyanoacrylate was performed in favour of interventional planning with a vascular specialist. The patient underwent uneventful recovery and no recurrence was seen after 6 months of follow-up.</p> Conclusion <p>This case reinforces the need for heightened clinical suspicion for AVMs in patients presenting with unexplained post-extraction swelling or pulsatile mandibular lesions. It also highlights the superiority of MRI angiography over traditional imaging in such cases. Early diagnosis and a multidisciplinary approach are critical to prevent potentially fatal complications.</p>

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Intraosseous Arteriovenous Malformation of the Mandible: a Rare and Challenging Diagnosis

  • 期刊论文

  • 发表日期：

    2026年1月22日

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  • Hrithik Kaushal Jain,
  • Arushi Tomar

摘要

Background

Arteriovenous malformations (AVMs) are rare vascular anomalies and their intraosseous presentation in the mandible is exceptionally uncommon. Misdiagnosis can lead to catastrophic bleeding during routine dental procedures.

Purpose

This case report describes a rare instance of high-flow mandibular AVM mimicking a benign odontogenic lesion, underscoring the diagnostic challenges and the vital role of advanced imaging in timely intervention.

Result

A 22-year-old female presented with persistent swelling and pain in the lower left jaw one year following a traumatic extraction of the mandibular first molar. Clinical examination revealed a pulsatile swelling. Conventional radiography suggested a benign lesion; however, MRI with angiography confirmed a high-flow intraosseous AVM with arterial supply from the left buccal and facial arteries. Imaging findings, along with clinical features, led to the diagnosis of a high-flow mandibular AVM. Given the high risk of haemorrhage, surgical intervention in the form of Endovascular surgery with glue embolization using cyanoacrylate was performed in favour of interventional planning with a vascular specialist. The patient underwent uneventful recovery and no recurrence was seen after 6 months of follow-up.

Conclusion

This case reinforces the need for heightened clinical suspicion for AVMs in patients presenting with unexplained post-extraction swelling or pulsatile mandibular lesions. It also highlights the superiority of MRI angiography over traditional imaging in such cases. Early diagnosis and a multidisciplinary approach are critical to prevent potentially fatal complications.