Although AVMs are quite rare, at least two generalizations can be drawn from this case. First, don't rush into treatment. Time spent in the initial diagnosis and treatment planning is time well spent. Carefully evaluate the signs and symptoms, develop a good initial differential diagnosis, and if the facts just don't fit, expand your differential diagnosis. Second, take advantage of continuing education courses in oral diagnosis, oral pathology and oral medicine. This is certainly the best way to keep current, increase your diagnostic knowledge and expand your differential diagnoses. Finally, I hope this case presentation makes clear that what you don't suspect, you seldom see, and what you don't see can hurt you and your patients.