Nasopharyngeal angiofibroma
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Nasopharyngeal angiofibroma (also called juvenile nasopharyngeal angiofibroma) is a histologically benign but locally aggressive vascular tumor that grows in the back of the nasal cavity. It almost exclusively affects adolescent males. Patients with nasopharyngeal angiofibroma usually present with one-sided nasal obstruction and recurrent bleeding.
Differential Daignosis
- Ant. Choanal polyp
- Rhinosporidiosis
- Malignancy
- Chordoma
- Nasopharanageal cyst
- Pyogenic granuloma
Diagnosis
If nasopharyngeal angiofibroma is suspected based on physical exam (a smooth submucosal mass in the posterior nasal cavity), imaging studies such as CT or MRI should be performed. Biopsy can lead to extensive bleeding since the tumor is composed of blood vessels without a muscular coat.
Treatment
Nasopharyngeal angiofibroma is treated by surgery. Pre-surgery angiography may allow for embolization, reducing intraoperative blood loss. Patients with tumors that have extended into the cranial cavity or whose tumors can't be safely reached by surgery may receive radiation therapy. Endoscopy has recently been used in patients with tumors of limited extension that have been pre-operatively embolized.
References
- Richard R. Orlandi. Nose and sinuses from Oxford Textbook of Surgery - 2nd Ed. Peter J. Morris and William C. Wood editors, Oxford University Press, Oxford, UK, 2000.
- Douglas R, Wormald P (2006). "Endoscopic surgery for juvenile nasopharyngeal angiofibroma: where are the limits?". Curr Opin Otolaryngol Head Neck Surg. 14 (1): 1–5. PMID 16467630.