Stereotactic body radiation therapy is promising treatment for complex arteriovenous malformation of the neck: A case report
Evelyn O. Ilori, Timothy D. Smile, Tom Masaryk, Abraham Levitin, Mark Bain, Sarah Stock, Jonathan Lee, Eric Lamarre, Neil M. Woody, Shauna Campbell and Shlomo A. Koyfman
Arteriovenous malformations (AVMs) are disorganized collections of abnormal vasculature characterized by direct arterial-to-venous communication without an intervening capillary network. This high flow, low resistance system is often accompanied by rupture, hemorrhage, and/or ischemia-related symptoms. While management of intracranial AVMs is well-defined, extracranial AVMs, especially in the head and neck, can be clinically challenging due to high rates of recurrence, sensitive adjacent anatomy, and a paucity of large-scale studies [1-3].
Treatment of localized extracranial AVMs includes arterial embolization and/or surgical excision [4]. Aggressive resection often results in morbidity, may be partial or palliative, and the risk of hemorrhage can still be significant [5]. Stereotactic body radiotherapy (SBRT) is a contemporary, non-invasive, highly conformal radiotherapy (RT) technique that can facilitate safe delivery of high radiation doses required to induce progressive thrombosis that results in luminal obliteration. We present a rare case of a large AVM of the neck safely and effectively treated using SBRT.
Keywords: Stereotactic, SBRT, extracranial, neck, complex, arteriovenous malformation