母指に発生した動静脈奇形の1例

Digital Arteriovenous Malformation in a Thumb. Case Report

　右母指に発症した動静脈奇形を認め，外科的加療で良好な成績を得た．患者は68歳の女性で，3カ月前に右母指の拍動性腫瘤と疼痛を認め，当科を受診した．血管撮影において固有指動脈に螺旋状の血管とともに静脈も描出され，動静脈奇形の診断の下，手術療法を選択した．術中所見においては流入血管と流出血管を1本ずつ伴う紡錘形の異常血管(nidus)を認め，血管の結紮，切離を行った．本症例はnidusが紡錘形の腫瘤内に限局し，流入出血管を1本ずつ伴う形態であったため，摘出が容易であった．手指の動静脈奇形で本症例のような形態は比較的稀と思われた．

　We report a case of digital arteriovenous malformation (AVM) of the thumb that was treated surgically.　A 68-year-old female presented with a pulsatile tumor and pain in her right thumb.　Angiography showed a spiral-shaped mass involving the digital artery and vein.　A diagnosis of AVM was made, and surgical treatment was selected.　An abnormal spindle-shaped mass (nidus) with feeder and draining blood vessels was observed intraoperatively.　The tumor was resected, and the blood vessels were ligated, but revascularization was not performed.　Since the nidus was localized in the spindle-shaped mass together with the feeder and draining vessels, the tumor was easily excised.　Our patient's type of AVM was a relatively rare type of AVM in a digit.