High-Flow Congenital Arteriovenous Malformation of the Right Deltoid Muscle in a Pediatric Patient: A Case Report

Congenital arteriovenous malformations (AVMs) are rare vascular anomalies involving abnormal connections between arteries and veins, bypassing the capillary bed. High-flow AVMs may lead to complications such as pain, ulceration, and functional impairment. We report a case of a six-year-old girl with a high-flow AVM in the right deltoid muscle, initially diagnosed via Doppler ultrasound and confirmed by MRI. The patient presented with a progressively enlarging, painless swelling of the right shoulder. Management included super-selective embolization, followed by surgical resection due to symptom recurrence and persistent vascular shunting. Postoperatively, the patient experienced improved shoulder mobility and pain reduction. The treatment plan involved a staged approach, with initial embolization to reduce blood flow, followed by surgical excision to prevent recurrence. The surgical resection was performed soon after the second embolization. Postoperative care included pain management and physiotherapy for optimal recovery. This case emphasizes the importance of early diagnosis, multimodal intervention, and long-term follow-up in pediatric AVMs. Future studies should focus on recurrence predictors, optimal timing for surgical resection post-embolization, and the role of genetic factors in AVM development.