Pulsatile scrotum

A 3-year-old boy presented with swelling of scrotum and left gluteal region that had increased in size since birth. A warm, erythematous pulsatile mass involved the scrotum and extended into the left gluteal region. There was evidence of scrotal bruit and thrill, suggestive of arteriovenous malformation (AVM). Magnetic resonance angiography confirmed multiple, tortuous feeders from the left internal iliac artery, consistent with AVM. Treatment was a combination of super-selective angio-embolisation and surgical resection.