[Bilateral Thoracoscopic Surgery for Bilateral Pulmonary Arteriovenous Malformations:Report of a Case].

Abstract

Pulmonary arteriovenous malformation (PAVM) is a congenital vascular anomaly that forms a shunt between the pulmonary artery and vein. It is frequently detected incidentally in asymptomatic patients. We encountered a 69-year-old female patient with bilateral PAVMs that were incidentally detected on abdominal computed tomography( CT) performed for a detailed examination of appendicitis. Abdominal CT revealed nodular opacities with contrast enhancement in the middle lobe of the right lung and the lingular segment of the left lung. They were further examined, and a diagnosis of PAVMs measuring 14 mm and 13 mm, respectively, was made. No arteriovenous malformations were identified in other organs, and no findings suggestive of hereditary hemorrhagic telangiectasia were observed. Both lesions were located in the peripheral regions directly beneath the pleura and had a diameter of 10 mm or more. Thus, surgical resection was considered indicated, and the patient underwent thoracoscopic partial lung resection. The lesions were easily identified and resected without complications. Although percutaneous transcatheter embolization is minimally invasive, it may be difficult to perform for peripheral and large-diameter lesions. Therefore, surgery may be an effective treatment option for peripheral PAVMs, as in the case of this patient. We report a case of bilateral PAVMs that were incidentally detected and safely treated by thoracoscopic surgery.