PDF(Pubmed)
Abstract：
UNASSIGNED: Arteriovenous malformations (AVM) are developmental vascular malformations consisting of abnormal arteriovenous shunts surrounding a central nidus. These lesions are relatively uncommon, comprising just 7% of all benign soft-tissue masses. Most AVMs occur in the brain, neck, pelvis, and lower extremity and rarely manifest in the foot. When they do form in the foot, non-specific pain and the absence of clinical features contribute to the high rate of misdiagnosis on initial presentation. Although surgical excision combined with embolotherapy has emerged as the preferred treatment for large AVM, controversy exists over the best treatment for small lesions in the foot.
UNASSIGNED: A 36-year-old Afro-Caribbean man was referred to the clinic with a 2-year history of increasing pain in his forefoot, affecting his ability to stand or walk comfortably. There was no history of trauma, and despite changing his footwear, the patient continued to have significant pain. Clinical examination was unremarkable except for mild tenderness over the dorsum of his forefoot, and radiographs were normal. A magnetic resonance scan reported an intermetatarsal vascular mass but could not exclude malignancy. Surgical exploration and en bloc excision confirmed the mass to be an AVM. One year post-surgery, the patient remains pain-free with no evidence of recurrence.
UNASSIGNED: The rarity of AVM in the foot, combined with normal radiographs and non-specific clinical signs, contributes to the long delay in diagnosing and treating these lesions. Surgeons should have a low threshold for obtaining magnetic resonance imaging in cases of diagnostic uncertainty. En bloc surgical excision is an option for treating small suitably located lesions in the foot.
UNASSIGNED: A 36-year-old Afro-Caribbean man was referred to the clinic with a 2-year history of increasing pain in his forefoot, affecting his ability to stand or walk comfortably. There was no history of trauma, and despite changing his footwear, the patient continued to have significant pain. Clinical examination was unremarkable except for mild tenderness over the dorsum of his forefoot, and radiographs were normal. A magnetic resonance scan reported an intermetatarsal vascular mass but could not exclude malignancy. Surgical exploration and en bloc excision confirmed the mass to be an AVM. One year post-surgery, the patient remains pain-free with no evidence of recurrence.
UNASSIGNED: The rarity of AVM in the foot, combined with normal radiographs and non-specific clinical signs, contributes to the long delay in diagnosing and treating these lesions. Surgeons should have a low threshold for obtaining magnetic resonance imaging in cases of diagnostic uncertainty. En bloc surgical excision is an option for treating small suitably located lesions in the foot.
摘要：
■动静脉畸形（AVM）是发育性血管畸形，由中央眼窝周围的异常动静脉分流组成。这些病变相对不常见，仅占所有良性软组织肿块的7%。大多数AVM发生在大脑中，脖子,骨盆,和下肢，很少出现在脚上。当它们在脚上形成时，非特异性疼痛和缺乏临床特征导致初次就诊时误诊率高。尽管手术切除联合栓塞治疗已成为大型AVM的首选治疗方法，关于足部小病变的最佳治疗方法存在争议。
一名36岁的非洲裔加勒比男子被转诊到诊所，有2年的前脚疼痛加剧，影响他舒适站立或行走的能力。没有外伤史,尽管换了鞋,患者继续有明显的疼痛。临床检查不明显，除了前脚背部有轻度压痛，X光片正常.磁共振扫描报告了meta骨间血管肿块，但不能排除恶性肿瘤。手术探查和整体切除证实肿块为AVM。手术后一年,患者保持无痛状态,无复发迹象.
■AVM在脚下的稀有性，结合正常的X线片和非特异性临床体征，导致这些病变的诊断和治疗延误。在诊断不确定的情况下，外科医生获得磁共振成像的阈值应该很低。整块手术切除是治疗足部小的适当位置病变的一种选择。
一名36岁的非洲裔加勒比男子被转诊到诊所，有2年的前脚疼痛加剧，影响他舒适站立或行走的能力。没有外伤史,尽管换了鞋,患者继续有明显的疼痛。临床检查不明显，除了前脚背部有轻度压痛，X光片正常.磁共振扫描报告了meta骨间血管肿块，但不能排除恶性肿瘤。手术探查和整体切除证实肿块为AVM。手术后一年,患者保持无痛状态,无复发迹象.
■AVM在脚下的稀有性，结合正常的X线片和非特异性临床体征，导致这些病变的诊断和治疗延误。在诊断不确定的情况下，外科医生获得磁共振成像的阈值应该很低。整块手术切除是治疗足部小的适当位置病变的一种选择。
