Microvascular proliferation in arteriovenous malformation of the hand worsens during pregnancy: a case report.

Autor:	Utami AM; Department of Pathology.; Department of Pathology Anatomy, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia., Horbach SER; Department of Plastic Surgery, Amsterdam University Medical Center, AMC, University of Amsterdam, Amsterdam., Meijer-Jorna LB; Symbiant Pathology, NWZ - Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands., Waas ISE; Department of Pathology., de Boer OJ; Department of Pathology., van der Wal AC; Department of Pathology., van der Horst CMAM; Department of Plastic Surgery, Amsterdam University Medical Center, AMC, University of Amsterdam, Amsterdam.
Jazyk:	angličtina
Zdroj:	Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2023 Apr 12; Vol. 85 (4), pp. 1262-1269. Date of Electronic Publication: 2023 Apr 12 (Print Publication: 2023).
DOI:	10.1097/MS9.0000000000000507
Abstrakt:	Arteriovenous malformations (AVMs) are rare congenital disorders characterized by episodes of disproportionate growth that can cause pain and severe bleeding, with microvascular proliferation (MVP) associated with these episodes. Hormonal influences can also worsen the symptoms in patients with AVM. Case Presentation: This case report presents a female patient with congenital vascular malformations of the left hand since birth, whose symptoms worsened during puberty and pregnancy, ultimately leading to amputation of the left hand due to unbearable pain and loss of function. Pathologic analysis revealed substantial MVP activity within the tissues of the AVM, with an expression of receptors for estrogen, growth hormone, and follicle-stimulating hormone in the vessels of the AVM, including MVP areas. Resected materials not related to pregnancy revealed chronic inflammation and fibrosis but hardly any MVP. Discussion and Conclusion: These findings suggest a role for MVP in the progressive growth of AVM during pregnancy, with a potential role for hormonal influences. The case highlights the relationship between AVM symptoms and size during pregnancy and the pathological findings of MVP areas within the AVM with hormone receptor expression on proliferating vessels in resected materials. Competing Interests: The authors declare that they have no financial conflict of interest with regard to the content of this report.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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