A rare case of a intraosseous arteriovenous malformation of the temporomandibular joint and mandible – Case report and literature review

INTRODUCTION: This case report looks at a 47 year-old patient, presenting with a rapid onset mass of the left face. This report examines the case, the investigations undertaken, its management and undertakes a literature review of this uncommon condition and rare presentation. PRESENTATION OF CASE: This patient had experienced functional deterioration, restriction and an evident swelling of the left face. Having identified the mass to arise from the mandibular condyle, an incisional biopsy was undertaken. The histology was suggestive of an arteriovenous malformation. Surgery was undertaken to excise the entire left mandibular condyle along with the lesion and then replace the temporomandibular joint with a custom made prosthesis. DISCUSSION: Arteriovenous malformations, or Haemiangiomas, can arise in any part of the body and can often grow over time. Although benign, lesions can be locally invasive and distort anatomy, resulting in functional issues. Their risk for hemorrhage and potentially significant blood losses is also a risk factor in their presence. Rarely arteriovenous malformations can occur in hard tissue, as in this case distorting and obliterating the temporomandibular joint. One’s only recourse is to remove and eliminate the lesion, however in cases such as this significant morbidity could ensue due to functional deficit. Hence consideration must be given to reconstruction. CONCLUSION: Having excised the mass and reconstructed the temporomandibular joint with a titanium prosthesis, the patient experienced a good recovery with a return to normality.