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Bilateral, independent juvenile nasopharyngeal angiofibroma: case report

Published online by Cambridge University Press:  28 August 2015

M-L Mørkenborg ,
M Frendø ,
T Stavngaard  and
C Von Buchwald
M-L Mørkenborg*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital Rigshospitalet, Denmark
M Frendø
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital Rigshospitalet, Denmark
T Stavngaard
Affiliation:
Department of Neuroradiology, Copenhagen University Hospital Rigshospitalet, Denmark
C Von Buchwald
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital Rigshospitalet, Denmark
*
Address for correspondence: Dr Marie-Louise Mørkenborg, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital Rigshospitalet, DenmarkE-mail:ml.morkenborg@gmail.com
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Abstract

Background:

Juvenile nasopharyngeal angiofibroma is a benign, vascular tumour that primarily occurs in adolescent males. Despite its benign nature, aggressive growth patterns can cause potential life-threatening complications. Juvenile nasopharyngeal angiofibroma is normally unilateral, originating from the sphenopalatine artery, but bilateral symptoms can occur if a large tumour extends to the contralateral side of the nasopharynx. This paper presents the first reported case of true bilateral extensive juvenile nasopharyngeal angiofibroma involving clinically challenging pre-surgical planning and surgical strategy.

Case report:

A 21-year-old male presented with increasing bilateral nasal obstruction and discharge. Examination revealed tumours bilaterally and imaging demonstrated non-contiguous tumours. Pre-operative angiography showed strictly ipsilateral vascular supplies requiring bilateral embolisation. Radical removal performed as one-step, computer-assisted functional endoscopic sinus surgery was performed. The follow-up period was uncomplicated.

Conclusion:

This case illustrates the importance of suspecting bilateral juvenile nasopharyngeal angiofibroma in patients presenting with bilateral symptoms. Our management, including successful pre-operative planning, enabled one-step total removal of both tumours and rapid patient recovery.

Keywords

Bilateral Nasal ObstructionNasopharynxNasopharyngeal NeoplasmsAngiofibromaHead And Neck NeoplasmsTherapeutic Embolization
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 10 , October 2015 , pp. 1032 - 1035
Copyright
Copyright © JLO (1984) Limited 2015 

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References

1Neel, HB, Whicker, JH, Devine, KD, Weiland, LH. Juvenile angiofibroma. Am J Surg 1973;126:547–56CrossRefGoogle ScholarPubMed
2Glad, H, Vainer, B. Juvenile nasopharyngeal angiofibromas in Denmark 1981–2003: diagnosis, incidence, and treatment. Acta Otolaryngol 2007;127:292–9CrossRefGoogle ScholarPubMed
3Paris, J, Guelfucci, B, Moulin, G, Zanaret, M, Triglia, JM. Diagnosis and treatment of juvenile nasopharyngeal angiofibroma. Eur Arch Otorhinolaryngol 2001;258:120–4CrossRefGoogle ScholarPubMed
4Rha, KS, Byun, SN, Kim, TH, Kim, YM. Bilateral juvenile nasopharyngeal angiofibroma. Otolaryngol Head Neck Surg 2003;128:891–3CrossRefGoogle ScholarPubMed
5Wu, EC, Chark, DW, Bhandarkar, ND. Bilateral juvenile nasopharyngeal angiofibroma: report of a case. Int Forum Allergy Rhinol 2014;4:603–6CrossRefGoogle ScholarPubMed
6Radkowski, D, McGill, T, Healy, GB, Ohlms, L, Jones, DT. Angiofibroma. Changes in staging and treatment. Arch Otolaryngol Head Neck Surg 1996;122:122–9CrossRefGoogle ScholarPubMed
7Girgis, IH, Fahmy, SA. Nasopharyngeal fibroma: its histo-pathological nature. J Laryngol Otol 1973;87:1107–23CrossRefGoogle ScholarPubMed
8Bremer, JW, Neel, HB, DeSanto, LW, Jones, GC. Angiofibroma: treatment trends in 150 patients during 40 years. Laryngoscope 1986;96:1321–9CrossRefGoogle Scholar
9Gomaa, MA, Hammad, MS, Abdelmoghny, A, Elsherif, AM, Tawfik, HM. Magnetic resonance imaging versus computed tomography and different imaging modalities in evaluation of sinonasal neoplasms diagnosed by histopathology. Clin Med Insights Ear Nose Throat 2013;6:9–15CrossRefGoogle ScholarPubMed
10Lloyd, G, Howard, D. Imaging for juvenile angiofibroma. J Laryngol Otol 2000;114:727–30CrossRefGoogle ScholarPubMed
11Ballah, D, Rabinowitz, D, Vossough, A, Rickert, S, Dunham, B, Kazahaya, K et al. Preoperative angiography and external carotid artery embolization of juvenile nasopharyngeal angiofibromas in a tertiary referral paediatric centre. Clin Radiol 2013;68:1097–106CrossRefGoogle Scholar
12Khoueir, N, Nicolas, N, Rohayem, Z, Haddad, A, Abou Hamad, W. Exclusive endoscopic resection of juvenile nasopharyngeal angiofibroma: a systematic review of the literature. Otolaryngol Head Neck Surg 2014;150:350–8CrossRefGoogle ScholarPubMed