Extranasopharyngeal Angiofibroma of the Nasal Septum

Doğan, Sedat; Yazıcı, Haşmet; Baygit, Yusuf; Metín, Mehmet; Soy, Fatih Kemal

doi:10.1097/scs.0b013e318290344d

Cited by 11 publications

(14 citation statements)

References 14 publications

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“…Many of these considerations may sufficiently explain the aetiology of JAF, but the clinical data of ENAs favour the possibility of other aetiological factors, as there is a much more balanced sex ratio, tumours occur in female and very young as well as elderly patients, and may present far away from an assumed nidus and the sphenoid bone. It was suggested that embryonic ectopic tissue remnants during the development of the nasal septum were the origin of septal ENAs . Probably, the periosteum of the perpendicular plate of the ethmoid bone is as an abnormal presentation of the fascia basalis .…”

Section: Discussionmentioning

confidence: 99%

“…This is the most important criterion to distinguish an angiofibroma from other tumours. Dogan et al . stated that ENAs have interstitial stromal predominance with less vascular elements on histopathologic examination, like that of longstanding JAF.…”

Section: Discussionmentioning

confidence: 99%

“…27 ENAs. 69,70 Probably, the periosteum of the perpendicular plate of the ethmoid bone is as an abnormal presentation of the fascia basalis. 8,71 However, the aetiology of ENAs affecting the inferior turbinate distinct from the ethmoid bone remains unclear.…”

Section: Therapeutic Approachmentioning

confidence: 99%

“…This is the most important criterion to distinguish an angiofibroma from other tumours. Dogan et al 69…”

Section: Histology and Immunohistochemistrymentioning

confidence: 99%

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Extranasopharyngeal angiofibroma revisited

Windfuhr

Vent

2017

Clinical Otolaryngology

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Background Angiofibromas in the head and neck region usually arise in the nasopharynx, but may also occur elsewhere. This study aims at evaluating the incidence and clinical features of extranasopharyngeal angiofibroma (ENA). Material and Methods Systematic review of the literature (Medline® and Google™) up to 31 December 2015. Results 174 cases of ENA were retrieved from a total of 170 publications. In contrast to former publications and previous understanding, the nasal septum was by far the most common site of the disease. Four patients had a congenital lesion, the oldest patient was 87 years old (mean: 28.7 years; median: 23 years). Male gender was predominantly affected, but the sex ratio was more balanced (2.13:1) than in previous reports in the literature until 12/2015. The majority of patients presented with nasal obstruction, either in combination with epistaxis (25.8%) or other symptoms (12.6%). Symptoms had developed within 13.1 months on average (median: 4 months). Brisk bleeding resulted in 11 of 43 biopsy procedures. Surgical resection as first‐line therapy was performed in 170 patients. A tumour regrowth within 12 months was registered in four patients. Conclusion The increasing awareness of ENA and the willingness to publish case reports—not only in Medline‐listed journals—resulted in a significant increase of published case reports lately. Although extremely rare, ENAs have to be taken into account in the differential diagnosis of unclear masses, particularly in adult patients presenting with a rapidly developing nasal obstruction resulting from a nasal septum tumour. Female gender or normal vascularity does not exclude the diagnosis. Transnasal resection is sufficient in most cases, and recurrences are rare. Pathologists as well as clinicians should consider ENA in their differential diagnosis of any mass of the upper airway.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Therapeutic Approachmentioning

confidence: 99%

“…This is the most important criterion to distinguish an angiofibroma from other tumours. Dogan et al 69…”

Section: Histology and Immunohistochemistrymentioning

confidence: 99%

See 2 more Smart Citations

Extranasopharyngeal angiofibroma revisited

Windfuhr

Vent

2017

Clinical Otolaryngology

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“…Angiofibromas of the nasal septum is extremely [2]. Site of origin of nasal septal angiofibromas (NSAs) previously described includes the anterior 1/3 of septum (cartilagenous septum), bony cartilaginous junction, as well as perpendicular plate of ethmoid [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. This varied site of origin within the nasal septum suggests the possibility of the tumour arising from ectopic tissue due to migration error during development of the nasal septum [2].…”

Section: Discussionmentioning

confidence: 99%

Nasal Septal Angiofibroma in a Post-Menopausal Woman: A Rare Entity

Ewe

Dayana

Fadzilah

et al. 2015

JCDR

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A 67-year-old lady presented to the Otorhinolaryngology clinic with complaints of right nasal obstruction for the past 6 months. She had no symptoms of persistent rhinorrhoea, recurrent epistaxis, anosmia, facial pain, facial numbness, headache, epiphora and diplopia. She had neither accompanying ear or throat symptoms nor preceding history of trauma or infection. She was a non-smoker, with no known occupational exposure risk factors. Endoscopic examination revealed a firm, smooth surface lobulated red mass arising from the right anterosuperior septum impinging on the inferior turbinate. The left nasal cavity looked normal. The nasopharynx, oropharynx and larynx were otherwise normal. There were no palpable cervical lymph nodes. Our initial working diagnosis was pyogenic granuloma, septal turbinate or nasal lymphoma. We proceeded with an office biopsy of the mass to rule out malignancy.Biopsy of the mass resulted in minimal bleeding and haemostasis was secured. Proliferation of thin-walled vessels in dense fibrous stroma was seen in the biopsy specimen, and histologically the mass was diagnosed as an angiofibroma [Table/ Fig-1]. A computerized tomography (CT) scan with contrast revealed a localised welldefined small mildly enhancing soft tissue lesion measuring 0.8cm by 0.4cm by 0.8cm, confined to the right anterosuperior septum with mild deviation of the nasal septum to the right. The soft tissue ABSTRACTJuvenile angiofibromas (JAs) are well-characterised in literature, arising typically in the posterolateral wall of the nasal cavity of young males. Numerous theories have been proposed to explain the occurrence of this unique and rare tumour. Angiofibromas originating in other sites within the head and neck have been described but this is exceedingly rare, constituting less than 2% of all diagnosed cases. Extranasopharyngeal angiofibroma is a rare lesion, and more importantly, controversial. It is not known whether it is actually a relative of the well-known JA that is seen exclusively in adolescent males. We present the case of a post-menopausal woman with unilateral nasal obstruction who was unexpectedly diagnosed as nasal septal angiofibroma.

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