Diagnosis and Management of an Ethmoid Sinus Arteriovenous Malformation

Arteriovenous Malformations (AVMs) are vascular anomalies composed of malformed arteries, veins, and capillaries. Although 50% of AVMs are located in the head and neck, they are rarely diagnosed in the paranasal sinuses. We report a rare case of an ethmoid sinus AVM in a patient who suffered from years of intermittent left forehead pressure. Non-contrast computed tomography demonstrated a 2 × 1.5 cm mass filling the left anterior ethmoid sinus and frontal recess, causing bony erosion of the lamina papyracea and lateral lamella of the cribriform plate, but significant hyperostosis of the fovea ethmoidalis. Magnetic resonance imaging with gadolinium contrast demonstrated heterogenous enhancement of the lesion without periorbital or dural invasion. The imaging findings suggested a vascular mass, but the preoperative differential diagnosis was broad. The mass was completely resected endoscopically, and final histopathology revealed the lesion to be an AVM.