Juvenile nasopharyngeal angiofibroma, histopathology embolization, treatment, radiosurgery. Between 1948 and 1975, we have seen 48 patients with nasopharyngeal angiofibroma. Intracranial involvement has been reported to occur. It also may be referred to as juvenile nasopharyngeal angiofibroma jna. Imaging in the diagnosis of juvenile nasopharyngeal angiofibroma article pdf available in journal of clinical imaging science 3suppl 1. Angiofibroma is a benign noncancerous nasal cavity tumor that almost exclusively affects adolescent boys. The age range for this disease is 7 to 19 years old, with most people being diagnosed between 10 and 19 years old. Correlating histology, surgical approach and blood loss. Juvenile nasopharyngeal angiofibroma a histopathological. 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.
Nasal cavity, paranasal sinuses, nasopharynx nasopharyngeal angiofibroma. Most of the tumour vessels, which lacked elastic laminae, were characterized by vascular walls of irregular thickness and variable muscle content. Nasopharyngeal angiofibroma lester dr thompson, md. Juvenile nasopharyngeal angiofibroma jna is a rare, histologically benign skull base tumor that develops in. We wish to highlight the importance of complete clinical examination and preoperative imaging in differentiating an ideal management of nasopharyngeal masses. It usually presents with a triad of unilateral nasal obstruction, episodes of spontaneous nasal bleeding and nasalnasopharyngeal mass. Intricate mixture of stellate and staghorn blood vessels with variable vessel wall thickness ranging from single layer of endothelium to variable smooth muscle coat. Review article nasopharyngeal angiofibroma ashutosh hota s. It is an aggressive neoplasm and shows a propensity for destructive local spread often extending to the base of the skull and into the cranium. Juvenile angiofibroma rads see also with virtual slide. Nasopharyngeal angiofibroma an overview sciencedirect.
Recent reports have suggested that radiotherapy may be preferable to other forms of treatment of juvenile nasopharyngeal angiofibroma. The juvenile nasopharyngeal angiofibroma is a benign neoplasm of the posterior nasopharynx it occurs almost exclusively in adolescent males, with an average age at diagnosis of 15 years old. Angiofibroma juvenile nasopharyngeal angiofibroma upmc. Nasopharyngeal angiofibroma histopathology youtube. Dermal dendritic cells usually stain for factor xiiia. Common symptoms include epistaxis and nasal obstruction. Forces institute of pathology no female patients were. Surgical experience with nasopharyngeal angiofibroma. 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. Juvenile nasopharyngeal angiofibroma jna is a rare benign tumor. Juvenile nasopharyngeal angiofibroma 420 introduction juvenile nasopharyngeal angiofibroma jna represents 0.
Juvenile nasopharyngeal angiofibroma makhasana ja, kulkarni ma. Angiofibroma is a pink, firm, 1 to 2mm domeshaped papule most commonly located over the nasal bridge and cheeks fig. This is an uncommon tumour of the posterior nasal cavity and lateral nasopharynx. Goldstandard treatment consists in surgical removal, which. A juvenile nasopharyngeal angiofibroma jna is a growth in the area behind the nose. Pdf imaging in the diagnosis of juvenile nasopharyngeal. We report the case of a years old, 52 kg, asa1, who was scheduled for the resection of an angiofibroma invading facial sinuses and internal carotid artery, and submitted to external carotid and internal maxillary arteries embolization one.
In places endothelial cells were only separated from. Youll hear about new websites, ipad apps, pathcasts, and other educational materials. The clinical and imaging materials of 51 cases of jna diagnosed at our hospital between 1981 and 2011 were collected and. Fibroangioma, histopathology, juvenile nasopharyngeal angiofibroma, nasopharyngeal neoplasms, surgical approval. Angiofibroma juvenil pdf juvenile nasopharyngeal angiofibromas jna are a rare benign but locally aggressive vascular tumor. Juvenile nasopharyngeal angiofibroma electronic journal of. Nasopharyngeal angiofibroma an overview sciencedirect topics. These growths are benign not cancer, but can damage nerves and bones and block ear and sinus drainage. Nasopharyngeal cancer causes, risk factors, and prevention. The jna juvenile nasopharyngeal angiofibroma is a rare neoplasm, of benign histology, that affects almost exclusively male sex adolescent. Juvenile nasopharyngeal angiofibroma iowa head and neck. A juvenile nasopharyngeal angiofibroma jna is a noncancerous tumor made up of blood vessels that grow at the posterior aspect of the nose.
Nasopharyngeal angiofibroma johns hopkins surgical. Juvenile nasopharyngeal angiofibroma jna springerlink. Nasopharyngeal angiofibroma naf is a highly vascular, histologically benign. In 1906 chareau revived the interest in the study of juvenile nasopharyngeal angiofibroma. Juvenile nasopharyngeal angiofibroma etiology, pathology. The nasopharyngeal angiofibroma jama otolaryngologyhead.
Classically adolescent males with recurrent nose bleeds. Angiofibroma nasofaring belia pdf juvenile nasopharyngeal angiofibroma is a pathologically benign yet locally aggressive and destructive vascular lesion of head and neck. Most of the patients presented at an advanced stage. These tumors differed from a n ordinary fibroma in the respect that the vascular elements represented at least one important component of the tumor, and the term juvenile nasopharyngeal angiofibroma as used by martin et al. Juvenile primary extranasopharyngeal angiofibroma, presenting as. Desmoplastic response of the nasopharyngeal periosteum or embryonic fibrocartilage between the basiocciput and the basisphenoid. Malignancy mimicking juvenile nasopharyngeal angiofibroma. Juvenile nasopharyngeal angiofibroma jna is a rare benign tumor arising predominantly in the nasopharynx of adolescent males. The nasopharyngeal angiofibroma is an aggressive, vascular tumor that may represent a challenge for the anesthesiologist by the risk of profuse bleeding. Review article nasopharyngeal angiofibroma ashutosh hota. Nasopharyngeal angiofibroma symptoms aurora health care.
Histologically, angiofibromas are characterized by fibrosis of the dermis and blood vessels. Since it occurs in the second decade of life, it is proposed that nasopharyngeal angiofibroma is a testosterone dependent tumour a nidus of hamartomatous vascular tissue in. Given the strict epidemiology, hormonal influences seem likely as investigators have revealed the presence of androgen, testosterone, and dihydrotestosterone receptors 3, 4 and lack. Given the strict epidemiology, hormonal influences seem likely as investigators have revealed the presence of androgen, testosterone, and dihydrotestosterone receptors 3, 4 and. Journal of oral and maxillofacial pathology jomfp is the official publication of the indian association of oral and maxillofacial pathology. Despite continuous advance of chinese and international npc histopathological classification research, it was difficult to unify previous with current china classifications, and the china with world health organization who classifications.
At age 19, routine sigtnoidoscopic surveil lance led to the diagnosis of fap, and he underwent subto tal colectomy. Carcinoma, endoscopic approach to juvenile nasopharyngeal angiofibroma, nasopharynx. Nasopharyngeal angiofibroma evaluation and management 44 p j m h s vol. To describe a clear and simplified classification system for juvenile nasopharyngeal angiofibroma jna, and to describe suitable management options.
The juvenile nasopharyngeal angiofibroma jna is a histological benign tumor, almost exclusive of male adolescents, with an incidence of 1. 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 is the most common benign tumour of the nasopharynx it is usually seen in males in the second decade of life and usually presents with recurrent profuse epistaxis etiology. Juvenile nasopharyngeal angiofibroma jna is a rare, benign neoplasm that accounts for less than 0. 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. Pdf on may 1, 2010, s marc stokes and others published nasopharyngeal angiofibroma of the nasal. Radiotherapy is the treatment of choice for most patients. Nasopharyngeal angiofibroma is a benign but aggressive tumor of unknown etiology, typically occurring in adolescent males. Juvenile nasopharyngeal angiofibroma evaluation and workup return to. Nasopharyngeal angiofibroma is usually encapsulated and composed of vascular tissue and fibrous stroma with coarse or fine collagen fibers. Learn about the risk factors for nasopharyngeal cancer and what you might be able to do to help lower your risk. Thirtytwo cases of nasopharyngeal angiofibroma, including 2 recurrences, all of which had been excised from males between 7 and 25 years, were subjected to systematic immunohistochemical study.
Pdf histopathological classification of nasopharyngeal. Juvenile nasopharyngeal angiofibroma jna is a benign, locally aggressive tumor found commonly in young boys. They often grow quickly during puberty, then slow down or stop growing entirely after adolescence. Sclerosing naevus these usually do not exhibit vascular ectasia. A clinical, histopathological and immunohistochemical study of 42 cases with emphasis on stromal features. Nasopharyngeal angiofibroma in patients with familial. Juvenile nasopharyngeal angiofibroma radiology reference. S100 stain will highlight the melanocytes, and will be negative in fibrous papules. Juvenile nasopharyngeal angiofibroma has been documented since the time of hippocrates 4 bc. Given its vascularity, prominent flow voids are seen on mri leading to a salt and pepper appearance. Hence the name juvenile nasopharyngeal angiofibroma. Nasopharyngeal angiofibroma evaluation and management. Surgery is the treatment of choice for angiofibroma. Angiofibroma is a fibrous and vascular tumour that commonly occurs in adolescent males and involves the nasopharynx.
A dose of 3,000 rads in three weeks leads to thrombosis, fibrosis, and tumor regression, although a latent period up. Wed like to send you periodic updates regarding pathology educational materials released by our department. A risk factor is anything that raises your chance of getting a disease such as cancer. Despite its benign character, it is locally aggressive and vascular. Nasopharyngeal angiofibroma nasopharynx, head and neck, histopathology. The juvenile nasopharyngeal angiofibroma is a benign neoplasm of the posterior. There are, however, potentially serious short and longterm complications associated with the use of radiotherapy in the. Currently, at age 34, he is free of recurrent angiofibroma. A number of childhood conditions are characterized by angiofibromas, but the most common is tuberous sclerosis. Anesthetic management of nasopharyngeal angiofibroma. Epidemiology juvenile nasopharyngeal angiofibromas.
Angiofibroma nasofaring belia pdf juvenile nasopharyngeal angiofibroma is a pathologically benign yet locally aggressive and destructive vascular lesion of. Vessels are thinwalled, lack elastic fibers, have absent or incomplete smooth muscle, and vary in appearance from stellate or staghorn to barely conspicuous because of stromal compression. The incidence of juvenile angiofibroma is less than 0. Infact hippocrates goes on to describe a polyp in the nose which weeped blood. Juvenile nasopharyngeal angiofibroma jna is a rare and benign but locally in the nasopharynx and nasal cavity, leading to manifestations such as nasal. Thompson, in head and neck pathology second edition, 20. Juvenile nasopharyngeal angiofibromas are a rare benign, but locally aggressive, vascular tumors that occur almost exclusively in young men on imaging, they present as a vividly enhancing softtissue masses centered on the sphenopalatine foramen. Pdf nasopharyngeal angiofibroma of the nasal cavity. It is described as a rare nasopharyngeal angiofibroma.
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