A case of thyroid arteriovenous malformation with laryngeal extension

Abstract

A 26-year-old male visited our hospital due to anterior cervical swelling. MRI showed multiple flow voids within the lesion in the left lobe of the thyroid gland, and arteriovenous malformation （AVM） was suspected. The lesion extended toward the larynx, and its vascular pedicle was anastomosed to the superior laryngeal artery. Two days before surgery, angiography followed by arterial embolization was performed. Although the AVM was fed by superior and inferior thyroid and superior laryngeal arteries, the inferior thyroid artery was selectively embolized to avoid serious bleeding during the surgery. The AVM was resected with the left lobe of the thyroid gland following ligations of the feeding arteries. The caudolateral part of the thyroid cartilage was transiently removed, and then the AVM was extirpated. The inferior laryngeal nerve was identified and traced to the larynx using a nerve integrity monitor. Although immobility of the unilateral vocal fold was transiently observed, mobility was regained four months after the surgery.