Journal of
Neuroscience and Behavioral Health

  • Abbreviation: J. Neurosci. Behav. Health
  • Language: English
  • ISSN: 2141-2286
  • DOI: 10.5897/JNBH
  • Start Year: 2009
  • Published Articles: 69

Full Length Research Paper

Rare presentation of ventricular arteriovenous malformation mimicking tumor lesion in a child: Systematic review and meta-analysis

Bianca F. Pires
  • Bianca F. Pires
  • Faculty of Medicine of Marília, Marília, São Paulo, R. Monte Carmelo, 800 - Fragata, Marília - SP, 17519-030, Brazil.
  • Google Scholar
Emanuele Pires Canela dos Santos
  • Emanuele Pires Canela dos Santos
  • Faculty of Medicine of Marília, Marília, São Paulo, R. Monte Carmelo, 800 - Fragata, Marília - SP, 17519-030, Brazil.
  • Google Scholar
Veronica Paduam
  • Veronica Paduam
  • Faculty of Medicine of Marília, Marília, São Paulo, R. Monte Carmelo, 800 - Fragata, Marília - SP, 17519-030, Brazil.
  • Google Scholar
Isis Franco Martin
  • Isis Franco Martin
  • Faculty of Medicine of Marília, Marília, São Paulo, R. Monte Carmelo, 800 - Fragata, Marília - SP, 17519-030, Brazil.
  • Google Scholar
Marcela Tanaka Alves de Lima
  • Marcela Tanaka Alves de Lima
  • Faculty of Medicine of Marília, Marília, São Paulo, R. Monte Carmelo, 800 - Fragata, Marília - SP, 17519-030, Brazil.
  • Google Scholar
Lorena Ingegneri Monteiro de Castro
  • Lorena Ingegneri Monteiro de Castro
  • Faculty of Medicine of Marília, Marília, São Paulo, R. Monte Carmelo, 800 - Fragata, Marília - SP, 17519-030, Brazil.
  • Google Scholar
Ana Beatriz da Silva Álvares
  • Ana Beatriz da Silva Álvares
  • Faculty of Medicine of Marília, Marília, São Paulo, R. Monte Carmelo, 800 - Fragata, Marília - SP, 17519-030, Brazil.
  • Google Scholar
Carla Cristina Barbosa Lopes
  • Carla Cristina Barbosa Lopes
  • Faculty of Medicine of Marília, Marília, São Paulo, R. Monte Carmelo, 800 - Fragata, Marília - SP, 17519-030, Brazil.
  • Google Scholar
Ruy Yoshiaki Okaji
  • Ruy Yoshiaki Okaji
  • Faculty of Medicine of Marília, Marília, São Paulo, R. Monte Carmelo, 800 - Fragata, Marília - SP, 17519-030, Brazil.
  • Google Scholar
Gabriel Rissoli Ramos
  • Gabriel Rissoli Ramos
  • Faculty of Medicine of Marília, Marília, São Paulo, R. Monte Carmelo, 800 - Fragata, Marília - SP, 17519-030, Brazil.
  • Google Scholar
Osmi Hamamoto
  • Osmi Hamamoto
  • Faculty of Medicine of Marília, Marília, São Paulo, R. Monte Carmelo, 800 - Fragata, Marília - SP, 17519-030, Brazil.
  • Google Scholar


  •  Received: 17 September 2024
  •  Accepted: 02 January 2025
  •  Published: 31 January 2025

Abstract

Ventricular arteriovenous malformations (AVMs) are rare vascular anomalies characterized by abnormal connections between arteries and veins, bypassing the capillary system. These lesions pose significant diagnostic challenges, particularly when mimicking tumors in pediatric patients. This systematic review with meta-analysis aims to investigate the clinical presentation, diagnostic tools, and treatment outcomes for ventricular AVMs misdiagnosed as tumors in children. Following the PRISMA protocol, a systematic search was conducted in PubMed, Scopus, and Web of Science through October 2024. Inclusion criteria encompassed pediatric cases (0 to 18 years) of ventricular AVMs diagnosed via neuroimaging or angiography. The meta-analysis employed a random-effects model to evaluate the prevalence of diagnostic errors and the relative risk (RR) of unnecessary surgical procedures. Studies with insufficient clinical data or involving only adults were excluded. Out of 60 initially identified studies, 25 met the inclusion criteria. The meta-analysis revealed that 18.7% (95% CI: 14.1 to 23.9) of cases were initially misdiagnosed as tumors. The RR of undergoing unnecessary surgery due to misdiagnosis was 2.45 (95% CI: 1.32 to 4.55; p < 0.05). The heterogeneity analysis indicated moderate variability across studies (I² = 68%). Accurate neuroimaging, especially magnetic resonance imaging (MRI) and digital subtraction angiography (DSA), was crucial for distinguishing AVMs from tumors. Ventricular AVMs mimicking tumors are rare but present a high risk of misdiagnosis, leading to inappropriate surgical interventions. This review emphasizes the importance of advanced neuroimaging and a multidisciplinary approach to improve diagnostic accuracy and treatment outcomes. Future research should focus on refining diagnostic protocols and exploring minimally invasive treatment strategies for these complex cases.

Key words: Ventricular arteriovenous malformation, ventricular tumor, pediatric tumor.