These features are compatible with juvenile angiofibroma, a benign but locally invasive tumor. Juvenile nasopharyngeal angiofibroma jna onset most commonly is in the second decade. Well circumscribed, variable pseudocapsule cellular tumor with fascicles or haphazard pattern. Surgical experience with juvenile nasopharyngeal angiofibroma. Juvenile nasopharyngeal angiofibroma for medical students. May 15, 2012 nasopharyngeal angiofibroma na is a rare, vascular tumor affecting adolescent males. The mass was free from septum, lateral wall and floor and was seen to be arising from the. Seven cases of nasopharyngeal angiofibroma treated surgically have been reported. Given the strict epidemiology, hormonal influences seem likely as investigators have revealed the presence of androgen, testosterone, and dihydrotestosterone receptors 3, 4 and. The juvenile nasopharyngeal angiofibroma jna is a highly nasoangiofibroma youth is a highly vascularized tumor almost exclusively male. Call 4166330001 or email us today to find out the best angiofibroma treatment option for you.
Juvenile nasopharyngeal angiofibroma jna is a benign neoplasm of the nasopharynx. Extranasopharyngeal angiofibromas ena arising exclusively from the nasal septum, nasal septal angiofibromas nsa, are extremely rare with only cases to date. It most commonly affects adolescent males and may grow into fissures of the. Juvenile nasopharyngeal angiofibromas jna are a rare benign but locally aggressive vascular tumor. The development of minimally invasive techniques has led to the increased use of endoscopic surgery for the treatment of nasopharyngeal angiofibroma 21making it ideal for angioribroma confined to the nasopharynx, nasal cavity, and sphenoid sinus with minimal extension into the pterygopalatine fossa 10 12 15 18 all the contents of this journal, except where. Nasopharyngeal angiofibroma is a histologically benign tumor composed of stroma and vessels.
Ppt journal juvenile nasopharynx angiofibroma radiation. This is a histologically benign lesion with very aggressive local behavior. Nasopharyngeal angiofibroma naf is a highly vascular, histologically benign, but sometimes locally aggressive tumor of the nasopharynx that occurs almost exclusively in males, usually between 10 and 20 years of age. Hunt, in diagnostic immunohistochemistry third edition, 2011. A rare case initially diagnosed as nasopharyngeal angiofibroma in an old patient and later diagnosed as pseudotumor by the careful histological and clinical observation was reported. Epidemiology juvenile nasopharyngeal angiofibromas. Additional interphase fish using a breakapart probe for the ncoa2 gene in the six fusionnegative cases did not reveal any split signals.
Nasopharyngeal angiofibroma is an uncommon, benign, fibrovascular tumor which exhibits a distinct predilection for adolescent males and accounts for less than 1% of all head and neck neoplasms 1, 2. Juvenile nasopharyngeal angiofibroma radiology case. The endoscopic resection is best indicated for small tumors confined to the nasopharynx, nasal cavity, ethmoid and sphenoid, and in some cases, tumors with extension into the pterygopalatine fossa 4. They often grow quickly during puberty, then slow down or stop growing entirely after adolescence. Sep 01, 2008 juvenile nasopharyngeal angiofibroma is a rare, benign tumor that occurs most often in adolescent males. Nasal septal angiofibroma, a subclass of extranasopharyngeal. Nasopharyngeal angiofibroma is a benign, vascular, polypoid fibrous mass in located in the the posterolateral wall of the nasal cavity. Frequently, the term juvenile is not included in the name of this tumor because this lesion may occur in adults occasionally, as well as in adolescents.
Article information, pdf download for denker operation is an effective surgical approach in. Juvenile nasopharyngeal angiofibroma jna is a rare tumor that predominantly occurs in adolescent males, the average age of occurence being 15. Accordingly, we studied patients with this lesion seen at the princess margaret hospital, toronto, in order to draw conclusions about these inconsistencies and. For a discussion of this entity please refer to the parent article. Juvenile nasal angiofibroma jna is a rare sinonasal tumor that is found almost exclusively in adolescent and young adult males. Patients usually present with nasal obstruction and epistaxis.
Review article nasopharyngeal angiofibroma ashutosh hota. Nasopharyngeal angiofibroma introduction juvenile nasopharyngeal angiofibroma jna is a benign, but locally aggressive and extremely vascular head and neck neoplasm, occurring almost exclusively in the nasopharynx of adolescent males. Pdf juvenile nasopharyngeal angiofibroma researchgate. This is a concise presentation for medical students especially from india. This is a concise presentation for medical students especially from. The angiofibroma right abuts normal sinonasal respiratory mucosa left, supporting an extrapharyngeal location.
Facial palsy following embolization of a juvenile nasopharyngeal. However, this case is not typical as it doesnt invade the nasal fossae. Juvenile nasopharyngeal angiofibroma is a benign, locally aggressive, vascular tumour of adolescent males. Pdf download for facial palsy following embolization of a juvenile. Angiofibromas are small, reddish brown or even fleshcolored, smooth, shiny, 0. The present article is a retrospective study of surgically treated patients of juvenile nasopharyngeal angiofibroma over a period of 5 years. Twelve cases of angiofibromata of the nasopharynx are described. Although the clinical presentation of these tumors differs vastly from the classically described juvenile nasopharyngeal angiofibroma jna, the histopathology is similar. Nasopharyngeal angiofibromas are rare vascular tumours seen in ent practice. It is almost exclusicely encountered in adolescent males 1. It is not as invasive as to surgery that is almost free of acute complications in. Juvenile nasopharyngeal angiofibroma is a rare, benign tumor that occurs most often in adolescent males. Juvenile nasopharyngeal angiofibroma is a pathologically benign yet locally aggressive and destructive vascular lesion of head and neck.
Nasopharyngeal angiofibroma na is a rare vascular tumor, which represents 0. In 1906 chareau revived the interest in the study of juvenile nasopharyngeal angiofibroma. Juvenile nasopharyngeal angiofibromas jna are a rare benign, but locally aggressive, vascular tumor. Denker operation is an effective surgical approach in managing. At the same time, it is the most common benign neoplasm of the nasopharynx. The vascular component of the lesion is prone to bleeding and responsible for its clinical malignancy. Although a histopathologically benign tumor of vascular origin, jna behaves locally invasive and. Common practice is to excise the tumor with open or endoscopic surgery. It invades the natural foramina and fissures usually present in the. Accordingly, we studied patients with this lesion seen at the princess margaret hospital, toronto, in order to draw conclusions about these inconsistencies and reported our findings in 1967 and 1970 6,7. Juvenile nasopharyngeal angiofibroma jna jnas are wellvascularized benign lesions typically occurring in adolescent males.
Juvenile nasopharyngeal angiofibromas occur almost exclusively in males and usually in adolescence 15 years. Longterm results of radiation therapy for juvenile nasopharyngeal angiofibroma. May, 2010 the preoperative diagnosis of nasopharyngeal angiofibroma can be a challenging task. We report the case of a 17yearold male who presented in 1995 with a mass filling the left posterior nasal cavity. However, the extensions of the tumor seem to be independent, each one with distinct behavior. In addition, the term nasopharyngeal is often used instead of nasal because angiofibromas that occur. Nasopharyngeal angiofibroma an overview sciencedirect. It is not as invasive as to surgery that is almost free of.
Thirtythree male patients aged between 8 and 25 years mean 15. It is the most common benign tumor of the nasopharnyx but only accounts for less than 0. Jul 15, 2015 juvenile nasopharyngeal angiofibroma jna is a benign neoplasm of the nasopharynx. Nasopharyngeal angiofibroma update on etiology, diagnosis, and management. The nasopharyngeal component with submucosal spread is clearly evident black asterisk. Pdf nasopharyngeal angiofibroma update on etiology. This is a classical presentation of juvenile nasopharyngeal angiofibroma. Though it is a benign tumor, it is locally invasive and can invade the nose, cheek, orbit. The biopsy showed thin walled and angulated blood vessels and the blood vessels were lined by a single layer of endothelial cells and showed an incomplete muscular wall which was suggestive of nasopharyngeal angiofibroma fig.
Diagnosis and treatment of juvenile nasopharyngeal angiofibroma. Angiofibroma nasofaring juvenile free download as pdf file. Juvenile nasopharyngeal angiofibroma jna is a relatively rare tumor occurring mainly in adolescent boys. In this video, we are going to see about juvenile nasopharyngeal angiofibroma. Nasopharyngeal angiofibroma an overview sciencedirect topics.
Preoperative embolization is also important to reduce intraoperative blood loss. Juvenile nasopharyngeal angiofibromas staging dr jeremy jones and assoc prof frank gaillard et al. As the tumor is largely spaceoccupying and highly vascular, patients typically. Do not attempt selfremoval of angiofibromas as that can often lead to permanent scars. Juvenile nasopharyngeal angiofibroma electronic journal of. Juvenile nasopharyngeal angiofibroma jna is a relatively rare tumor with an incidence of between 1. Jnas originate from the posterior choanal tissues and rapidly extend into the surrounding regions, including the nasopharynx, the orbits, and even the intracranial cavity. Intricate mixture of stellate and staghorn blood vessels with variable vessel wall thickness ranging from single layer of endothelium to variable smooth muscle coat. Nasopharyngeal angiofibroma and cancer shyni dharipelly. Juvenile nasopharyngeal angiofibroma is a benign but locally invasive tumor accounting for about 0. A 60yearold male who had a longstanding history of chronic sinusitis was found having anasopharyngeal tumor in the right nasal cavity and an ossified polyp in. Another case of recurring nasopharyngeal angiofibroma with lateral extension to peterygomaxillary fossa and cheek removed successfully by transpalatal and. Juvenile nasopharyngeal angiofibroma jna is a rare, benign, but locally aggressive tumor occurring almost exclusively in adolescent males. Even in patients who received preoperative embolization, a bloodfree surgical field may not be obtained because of collaterals and variable origin of the vidian.
Juvenile nasopharyngeal angiofibroma linkedin slideshare. A juvenile nasopharyngeal angiofibroma jna is a noncancerous tumor made up of blood vessels that grow at the posterior aspect of the nose. Juvenile nasopharyngeal angiofibroma jna is a histologically benign, but locally. Juvenile nasopharyngeal angiofibroma with orbital extension.
Angiofibroma removal in toronto dermatology centre is a commonly performed procedure with great results. Nasopharyngeal angiofibroma symptoms aurora health care. Review article nasopharyngeal angiofibroma ashutosh hota s. Radiotherapy of nasopharyngeal angiofibroma springerlink. Hippocrates described this tumor in the 5 th century bc, but friedberg first used the term angiofibroma in 1940.
There are many classification described although none is. Ppt juvenile nasopharyngeal angiofibroma powerpoint. Juvenile nasopharyngeal angiofibroma is a highly vascularized tumor found almost exclusively in adolescent males and it arises in the majority of the cases from the. Juvenile nasopharyngeal angiofibroma 420 introduction juvenile nasopharyngeal angiofibroma jna represents 0. Staging of juvenile nasopharyngeal angiofibromas is performed with crosssectional imaging and relies on the identification of local tumor extent, and invasion of adjacent spaces. It most commonly affects adolescent males because it is a hormonesensitive tumor. Fortythree cases of jna were treated at our institution from 1975 to 1999. Juvenile nasopharyngeal angiofibroma knowledge for medical. The juvenile nasopharyngeal angiofibroma has a characteristic growth in all directions from its origin. Juvenile nasopharyngeal angiofibroma with audio youtube. Management of juvenile nasopharyngeal angiofibroma.
We had recently a case of an extensive jna in the r nasal cavity extending from the anterior nares to the nasopha. Ppt journal juvenile nasopharynx angiofibroma free download as powerpoint presentation. Ten patients were adolescent males, 2 were females. Extension to intracranial cavity is not uncommon and presents difficulties in management. Nasoangiofibroma youth is a highly vascularized tumor almost exclusively male adolescents presentation. Juvenile angiofibroma is a rare benign lesion originating from the pterygopalatine. It is crucial to recognize these tumors on imaging as a biopsy can be disastrous due to their high vascularity. They are exclusively found in males and if diagnosed in a female patient, genetic testing.
Interphase fish on cut sections from nine additional cases of soft tissue angiofibroma using pools of bacs covering ahrr and ncoa2 yielded fusion signals in at least 10% of the nuclei in three cases. Diagnosis and treatment of juvenile nasopharyngeal. Review of the literature on the rare nasopharyngeal angiofibroma reveals a number of inconsistencies in the tumors spectrum, its behaviour and its response to treatment 15. Well circumscribed but unencapsulated polypoid fibrous mass, bleeds severely on manipulation and biopsy, may occlude nares. Reddy ka, mendenhall wm, amdur rj, stringer sp, cassisi nj.
Juvenile nasopharyngeal angiofibromas staging radiology. Adolescents and young adults between 14 and 25 years are affected, and there is a distinct male predominance. In the other type the vascular channels are made up. The aim of this retrospective study was to compare clinical and radiological findings and discuss optimal surgical approach in patients with juvenile nasopharyngeal angiofibroma jna. Pdf nasopharyngeal angiofibroma staging and selecting a. Infact hippocrates goes on to describe a polyp in the nose which weeped blood.
In fact, biopsy prior to definitive treatment is generally condemned as both unnecessary and hazardous. Mean age at diagnosis is 14 years may regress in late teens but may persist into adulthood rare in patients older than 25 years. Juvenile nasopharyngeal angiofibroma radiology reference. Juvenile nasopharyngeal angiofibroma romanian journal of. Juvenile nasopharyngeal angiofibroma is a pathologically benign yet locally aggressive and destructive vascular lesion of head and neck region typically affecting adolescent boys. Nasopharyngeal angiofibroma may be classified according to. Nasopharyngeal angiofibroma is a histologically benign but locally aggressive vascular tumor of the nasopharynx that arises from the superior margin of the sphenopalatine foramen and grows in the back of the nasal cavity. Due to aggressive local growth, skull base location and risk of profound hemorrhage, na is a challenge for surgeons. Toronto dermatology centre is located in toronto, ontario, and serves men and women in north york, vaughan, richmond hill, york, aurora. The diagnosis is predicated upon appropriate clinical history and the highly characteristic radiographic appearance.
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