Extranasopharyngeal Angiofibroma of the Frontal Sinus

Extranasopharyngeal angiofibroma in children: A case report

BACKGROUND

Sporadic cases of extranasopharyngeal angiofibroma in children, especially preschool children, have been reported in the literature.

CASE SUMMARY

We present a case of extranasopharyngeal angiofibroma in a 4-year-old boy. The presenting symptoms, imaging findings, treatment, histological appearance, and follow-up data are described in detail. For this patient, we performed embolization on two occasions, and then, resected the tumor completely. During the treatment, the patient developed a soft-palate perforation due to aseptic necrosis. However, the healing ability was good, and the perforation healed spontaneously. We additionally reviewed all pediatric cases of extranasopharyngeal angiofibroma published up to 30 June 2020 in the PubMed, Baidu Scholar, Scopus, and Web of Science databases. We identified 45 pediatric patients [average (10.98 ± 4.86), boys 39 (86.7%)]. The highest proportion of cases occurred in adolescence [22 (48.9%)]. The top three sites of occurrence of extranasopharyngeal angiofibroma in children were the maxillary sinus, nasal septum, and inferior turbinate.

CONCLUSION

Extranasopharyngeal angiofibromas can occur throughout childhood, and predominantly present with nasal obstruction and spontaneous rhinorrhagia.

Diode Laser Management of Primary Extranasopharyngeal Angiofibroma Presenting as Maxillary Epulis: Report of a Case and Literature Review

Juvenile nasopharyngeal angiofibroma is a rare vascular neoplasm, mostly occurring in adolescent males, and representing 0.05% of all head and neck tumors. Nevertheless, it is usually recognized as the most common benign mesenchymal neoplasm of the nasopharynx. Usually, it originates from the posterolateral wall of the nasopharynx and, although histologically benign, classically shows a locally aggressive behavior with bone destruction as well as spreading through natural foramina and/or fissures to the nasopharynx, nasal and paranasal cavities, spheno-palatine foramen, infratemporal fossa and, very rarely, to the cranial cavity. Extranasopharyngeal angiofibroma is considered a distinct entity due to older age at presentation, different localizations (outside the nasopharyngeal pterygopalatine fossa) and attenuated clinical course. Extranasopharyngeal angiofibroma has been sporadically described in the oral cavity. We report a case of extranasopharyngeal angiofibroma with primary and exclusive involvement of the adherent gingiva of the anterior maxilla, managed by preoperative diode laser trans-mucosal photocoagulation and subsequent surgical removal. The current literature on primary extranasopharyngeal angiofibroma is also reviewed.

Frontoethmoidal Extranasopharyngeal Angiofibroma With Orbital Pyocele

Significance StatementExtranasopharyngeal angiofibromas (ENA) are rare vascular tumors that do not conform to the clinical characteristics of typical nasopharyngeal angiofibromas. We present the management of an angiofibroma in a rare site, within the frontal sinus with a concomitant orbital pyocele, which was completely excised via an endoscopic approach. ENAs should be considered as a differential diagnosis in patients with sinonasal mass and epistaxis. Awareness of this rare entity will avoid radical surgery thus decreasing postoperative morbidity.