Extranasopharyngeal angiofibroma of the posterior nasal septum: a rare clinical entity

Atmaca, Sinan; Bayraktar, Cem; Yıldız, Levent

doi:10.5606/kbbihtisas.2013.29795

Cited by 15 publications

(29 citation statements)

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“…They occur more frequently in females, which accounts for 25–26 % of all cases [10, 14, 19]. They also develop in older age group than NA, with the mean age of presentation 22 years [10, 16, 19, 20].…”

Section: Discussionmentioning

confidence: 99%

Extranasopharyngeal angiofibroma: clinical and radiological presentation

Szymańska

Szymański

Morshed

et al. 2012

Eur Arch Otorhinolaryngol

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Nasopharyngeal angiofibroma (NA) is a rare, vascular tumor affecting adolescent males. Due to aggressive local growth, skull base location and risk of profound hemorrhage, NA is a challenge for surgeons. Angiofibromas have been sporadically described in extanasopharyngeal locations. We review ten cases of extranasopharyngeal angiofibroma (ENA) and discuss the incidence, clinical presentation and management of this pathology. The group consisted of 4 males and 5 females aged 8–49. There were 7 patients with nasal angiofibroma, 1 patient with laryngeal angiofibroma, 1 patient with oral angiofibroma and another patient with infratemporal fossa tumor. In patients with nasal angiofibroma most common presenting symptoms were nasal obstruction and epistaxis. Patients with laryngeal angiofibroma suffered from mild dysphagia and patients with the infratemporal fossa tumor had painless cheek swelling. In four patients with nasal tumor computed tomography (CT) demonstrated mass with strong to intermediate contrast enhancement. In one patient with nasal tumor carotid angiography demonstrated pathological vessels without intensive tumor blush. Infratemporal fossa tumor showed intensive contrast enhancement on CT and magnetic resonance imaging (MRI) scans, and abundant vascularity on angiography. Laryngeal and oral angiofibroma required no radiological imaging. Three nasal tumors were evaluated before introduction of CT to clinical practice. All patients underwent surgery. No recurrences developed. ENAs differ significantly from NAs regarding clinical and radiological presentations. They lack typical clinical and radiological features as they develop in all age groups and in females, may be less vascularised, arise from various sites and produce a variety of symptoms.

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Section: Discussionmentioning

confidence: 99%

Extranasopharyngeal angiofibroma: clinical and radiological presentation

Szymańska

Szymański

Morshed

et al. 2012

Eur Arch Otorhinolaryngol

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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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“…Also ENA presents in older age group more than NA, with mean age of 22 years and 17 years, respectively [3, 7], while for nasal vestibule angiofibroma the mean age is 43 years. The administration of contrast agent in NA leads to a strong and usually homogeneous enhancement on CT and MRI, while EN varies from strong to minimal or even no enhancement, due to the frequent poor vascularity of the tumor [10]. …”

Section: Discussionmentioning

confidence: 99%

Angiofibroma Originating outside the Nasopharynx: A Management Dilemma

Mahmood

Sheikh

Saey

et al. 2016

Case Reports in Otolaryngology

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Background. Angiofibroma is a benign tumor, consisting of fibrous tissue with varying degrees of vascularity, characterized by proliferation of stellate and spindle cells around the blood vessels. It most commonly arises from the nasopharynx, although it may rarely arise in extranasopharyngeal sites. Case Report. A 46-year-old male presented with left side nasal obstruction and epistaxis for one month. Clinical nasal examination revealed left sided polypoidal mass arising from the vestibular region of the lateral nasal wall. Results. CT scan and MRI showed highly vascular soft tissue mass occupying the anterior part of the left nostril. Preoperative selective embolization followed by transnasal excision was performed. Histopathological examination confirmed the diagnoses of nasal vestibular angiofibroma. Conclusion. Extranasopharyngeal angiofibroma is a very rare pathology. It should be kept in mind as a differential diagnosis with any unilateral nasal vestibular mass causing nasal obstruction and epistaxis. A biopsy without further investigation can cause life threatening bleeding in the patient.

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Extranasopharyngeal angiofibroma of the posterior nasal septum: a rare clinical entity

Cited by 15 publications

References 0 publications

Extranasopharyngeal angiofibroma: clinical and radiological presentation

Extranasopharyngeal angiofibroma: clinical and radiological presentation

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

Angiofibroma Originating outside the Nasopharynx: A Management Dilemma

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