Incidental diagnosis of a lingular pulmonary arteriovenous malformation in a 22-year-old female: a rare case report from Syria

Pulmonary arteriovenous malformations (PAVMs) are abnormal communications between pulmonary arteries and veins that bypass the normal pulmonary capillary bed. They are most commonly associated with hereditary hemorrhagic telangiectasia (HHT), while idiopathic cases are rare. PAVMs usually occur in the lower lobes and are more frequent in females, particularly during pregnancy. Although often clinically silent, they can present with dyspnea, hypoxemia, and cyanosis. This case is reported due to its rarity and as, to the best of our knowledge, the first documented surgically resected left lingular PAVM reported in Syria. A 22-year-old Syrian female, nulligravid, presented with unexplained dyspnea persisting for one year. Contrast-enhanced multidetector computed tomography (MDCT) of the chest revealed a PAVM in the left lingula, which was confirmed by histopathology. While endovascular embolization is the preferred treatment for PAVMs, the patient underwent complete surgical resection of the lingula. Postoperatively, vital signs and symptoms improved rapidly, and the procedure achieved a favorable outcome. This case highlights that PAVMs, although rare and often asymptomatic, can cause chronic dyspnea and may require surgical intervention when indicated. Reporting such cases contributes to clinical knowledge and awareness of management strategies in settings where endovascular treatment may not be feasible.