Scrotal arteriovenous malformation (AVM) successfully resected without angioembolization: A case report

INTRODUCTION AND IMPORTANCE

The main types of scrotal vascular lesions are varicocele, hemangioma, lymphangioma and arteriovenous malformation (AVM). AVM consists of network between arteries and veins without capillaries. It is the rarest type especially when in scrotum.

CASE PRESENTATION

A 24-year-old male patient presented with a skin deformity and painless swelling in the left scrotum. Physical examination revealed this swelling that extended to the inguinal region. Duplex Ultrasound (DUS) followed by Multi-slice Computed Tomography (MSCT) were performed to establish the diagnosis. Management depended on surgical excision without angioembolization. Preoperative sperm analysis showed oligoasthenozoospermia that improves significantly after treatment and 1 year of follow-up.

CLINICAL DISCUSSION

Surgical resection of scrotal AVM without embolization has been used in very few cases and has resulted in a satisfactory outcome with no signs of recurrence throughout the follow-up period.

CONCLUSION

Based on our experience, surgical excision without embolization is a reasonable alternative approach to treat scrotal AVM in low-income countries alongside avoiding the negative consequences of radiation therapy. Treatment should be considered when fertility is affected.

Angioembolization of Scrotal Arteriovenous Malformations: A Case Report and Literature Review

Arteriovenous malformations (AVMs) of the scrotum are rare lesions, usually diagnosed incidentally during the evaluation of scrotal masses or infertility. It could be presented with acute bleeding or acute pain. We are presenting a case of painless bilateral infiltrated scrotal mass (more advanced in the left side) developed dramatically over a year, no other symptoms existed. The diagnosis was made using duplex ultrasound (DUS), computed tomography arteriography (CTA), and digital subtraction angiography (DSA). Three sessions of angioembolization were performed and followed by surgical resection of the left side of the scrotum.