Juvenile nasopharyngeal angiofibroma tumor – Diagnosis and management in our tertiary hospital

Abstract

Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumor described by slow progression, vigorous growth, high vascularization, and increased recurrence rate. The aim of this article is to describe a case of JNA from our tertiary hospital and discuss the diagnosis and management in our current practice. A 16-year-old male patient presented with bleeding from the left nasal cavity. On examination, there was a non-pulsatile ovoid like mass occluding the entire left nasal cavity which was able to probe medially, superiorly, and laterally except inferiorly and on probing and it resulted in minimal bleed. Cold spatula test revealed decreased fogging on the left side. Contrast-enhanced computed tomography scan of the paranasal sinuses and nose showed the presence of a large ill-defined heterogeneously enhancing soft-tissue density mass lesion with its epicenter in posterior part of the left nasal cavity and left pterygopalatine fossa and was extending into the left orbit and left cavernous sinus. Complete embolization of the left nasopharyngeal vascular mass was done preoperatively. Two days post-embolization, surgical excision of JNA under general anesthesia was done. The approach was done through sublabial incision. This classic case of JNA was operated endoscopically because of its benefits over the conventional methods.