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Eugine R, Ps S, Bhardwaj A, Sahu MP. Challenges and innovations in managing a complex giant bilateral juvenile nasopharyngeal angiofibroma with intracranial extension. BMJ Case Rep 2024; 17:e258641. [PMID: 39174044 DOI: 10.1136/bcr-2023-258641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024] Open
Abstract
Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular, benign and locally aggressive tumour that predominantly affects adolescent males. Recognised for its persistence and propensity to recur, patients usually present with gradual development of symptoms such as epistaxis and nasal obstruction over several months to years. Diagnosis typically combines clinical assessments and radiographic studies, often involving preoperative angiography to identify feeder vessels and facilitate embolisation, reducing intraoperative bleeding during surgical interventions. A comprehensive approach to treatment, considering both tumour characteristics and patient well-being, is crucial, particularly when dealing with cases involving intracranial extension. Surgical excision remains the primary treatment for angiofibroma, though radiotherapy is considered for cases with intracranial extension. This case report outlines a case involving a young man in his 20s with a large bilateral JNA extending into the intracranial area. The patient underwent preoperative embolisation followed by surgical resection using a nasofrontomaxillary swing approach with a bifrontal craniotomy window. This alternative approach provided enhanced exposure to address the involvement of the infratemporal fossa, anterior and middle skull base. Postoperatively, residual intracranial tumour was managed with radiation therapy. Over a 2-year follow-up, the patient remains asymptomatic, with a minor postradiation reduction in the intracranial component's size.
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Affiliation(s)
- Reshma Eugine
- Otorhinolaryngology, All India Institute of Medical Sciences-Rishikesh, Rishikesh, India
| | - Suji Ps
- ENT, All India Institute of Medical Sciences-Rishikesh, Rishikesh, India
| | - Abhishek Bhardwaj
- Otorhinolaryngology, All India Institute of Medical Sciences-Rishikesh, Rishikesh, India
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2
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Elfstrand E, Löfvenberg C, Lundman L, Wikström J. A Rare Case of Angiofibroma Presenting as an Endolymphatic Sac Tumor. Laryngoscope 2024; 134:1897-1900. [PMID: 37721203 DOI: 10.1002/lary.31037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/09/2023] [Accepted: 08/22/2023] [Indexed: 09/19/2023]
Abstract
A 30-year-old man presented with minute-long episodes of vertigo and severe autophony. CVEMP showed a decreased threshold when testing the left side, potentially indicating SSCD. A subsequent MRI demonstrated a multi-lobulated, cystic mass in the temporal bone and the radiological diagnosis at that time was ELST. Tumor excision was performed, and microscopic examination of the excised material revealed fibrovascular tissue without signs of papillary or cystic projections. The conclusion of the histological assessment rendered a diagnosis of angiofibroma. We were unable to find a previous report of ENA originating around the endolymphatic sac. Laryngoscope, 134:1897-1900, 2024.
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Affiliation(s)
- Erika Elfstrand
- Department of Otolaryngology, Central Hospital, Karlstad, Sweden
| | | | - Lars Lundman
- Department of Otolaryngology, Central Hospital, Karlstad, Sweden
| | - Johan Wikström
- Department of Surgical Sciences, Unit of Neuroradiology, Uppsala University Sweden, Uppsala, Sweden
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Sikdar A, Khan S, Nivsarkar S, Phatak S. Juvenile Nasopharyngeal Angiofibroma in Adolescent Female with Subsequent ICA Canal Dehiscence: An Unknown Entity. Indian J Otolaryngol Head Neck Surg 2022; 74:4680-4687. [PMID: 36742805 PMCID: PMC9895723 DOI: 10.1007/s12070-021-03008-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/21/2021] [Indexed: 02/07/2023] Open
Abstract
Juvenile Nasopharyngeal Angiofibroma (JNA) is a benign vascular tumour typically occurring in adolescent males. Presentation beyond this age group and in female is rare. Classically it was surgically removed by various external approaches. Present gold standard of therapy is endoscopic excision. This is less morbid, avoids external scar and allows complete tumour removal under magnified view. Dehiscent internal carotid artery (ICA) canal is a rare condition which presents mostly as a pulsatile tinnitus or otalgia. Accidental injury to the exposed vessel during ear surgery may cause devastating consequences. Present case is a lady who was operated for left NPA 10 years back when she was 11 years age. Presently she presented with left ear pain which was diagnosed to be due to dehiscent ICA canal. We present a comprehensive review of world literature on the incidence of nasopharyngeal and extra-nasopharyngeal angiofibroma in women in the region of nose and para-nasal sinuses. There has been only 3 cases of NPA in adolescent females documented till date. This is the first documented case of NPA in adolescent female with subsequent ICA dehiscence. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-021-03008-7.
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Affiliation(s)
- Abhik Sikdar
- Department of ENT, Choithram Hospital And Research Centre, Indore, India
| | - Sidra Khan
- Department of ENT, Choithram Hospital And Research Centre, Indore, India
| | - Sameer Nivsarkar
- Department of ENT, Choithram Hospital And Research Centre, Indore, India
| | - Shrikant Phatak
- Department of ENT, Choithram Hospital And Research Centre, Indore, India
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4
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Behera G, Gupta V, Mishra UP, Tandon A. Extra Nasopharyngeal Angiofibroma Arising From Oropharynx: A Clinical Report. Indian J Otolaryngol Head Neck Surg 2022; 74:4646-4648. [PMID: 36742930 PMCID: PMC9895626 DOI: 10.1007/s12070-021-02956-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/19/2021] [Indexed: 02/07/2023] Open
Abstract
Angiofibroma arising from sites other than nasopharynx is rare and termed as Extra nasopharyngeal angiofibroma (ENA). ENAs commonly arise from nasal septum, maxillary sinus, and inferior turbinate. But angiofibroma arising from oropharynx have not been frequently reported. We present here a case of middle-aged male who presented with a large pedunculated oropharyngeal mass attached to palatopharyngeal fold. Endoscopic radiofrequency assisted transoral excision of mass was done. Histopathological features were consistent with angiofibroma arising from oropharynx. Patient recovered well with no evidence of recurrence till 18 months of follow up. In this report, we have tried to emphasize the diagnostic workup for oropharyngeal mass. This report also provides an insight into the clinical and pathological behavior of extra nasopharyngeal angiofibroma.
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Affiliation(s)
- Ganakalyan Behera
- Department of Otorhinolaryngology-Head and Neck Surgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh 462020 India
| | - Vikas Gupta
- Department of Otorhinolaryngology-Head and Neck Surgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh 462020 India
| | - Utkal Priyadarshi Mishra
- Department of Otorhinolaryngology-Head and Neck Surgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh 462020 India
| | - Ashwani Tandon
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh 462020 India
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Hassan MF, Nagi K, Saxena SK, Srinivas BH. Middle turbinate angiofibroma in an adolescent boy. BMJ Case Rep 2022; 15:e246490. [PMID: 35131785 PMCID: PMC8823056 DOI: 10.1136/bcr-2021-246490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2021] [Indexed: 11/04/2022] Open
Abstract
Bleeding nasal mass in adolescent boys has customarily been attributed to Juvenile nasopharyngeal angiofibroma. However, little is known regarding the extranasopharyngeal origin of angiofibroma, as highlighted in this case report of a 15-year-old boy who presented with recurrent epistaxis and nasal obstruction. On constructing a working diagnosis of nasal haemangioma, the patient was taken up for endoscopic excision under general anaesthesia. Intraoperative endoscopic findings and histopathological examination revealed the diagnosis of middle turbinate angiofibroma, which is an extremely rare extranasopharyngeal angiofibroma. Consequently, this represents the third described case of a juvenile angiofibroma arising from the middle turbinate.
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Affiliation(s)
- Mohamed Faizal Hassan
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Kezevino Nagi
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sunil Kumar Saxena
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Extranasopharyngeal Angiofibroma of the Natural Ostium of Maxillary Sinus. J Craniofac Surg 2021; 33:e298-e300. [PMID: 34560754 DOI: 10.1097/scs.0000000000008225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Extranasopharyngeal angiofibroma which occurs in all head and neck regions is extremely rare. Unlike most angiofibromas which show nasal congestion and recurrent epistaxis as their symptoms, extranasopharyngeal angiofibromas (ENAF) may lead to various symptoms depending on their location. Nasal septum is the most frequent site of origin of ENAF. No study of ENAF originating in natural ostium of maxillary sinus has been reported. We present a case of 27-year-old male who has extranasopharyngeal angiofibroma arising from the natural ostium of maxillary sinus in an adult patient whose symptom was right sided nasal obstruction. With this study, although uncommon, angiofibroma should be considered as a differential diagnosis in patient with mass lesion in the middle nasal meatus.
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Liu JY, Li SQ, Yao SJ, Liu Q. Omental mass combined with indirect inguinal hernia leads to a scrotal mass: A case report. World J Clin Cases 2021; 9:7850-7856. [PMID: 34621837 PMCID: PMC8462230 DOI: 10.12998/wjcc.v9.i26.7850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/06/2021] [Accepted: 08/04/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary omental tumors are uncommon, and omental fibromas account for 2% of these tumors. Due to the low incidence of omental fibromas and the limited relevant literature, it is challenging for clinicians to make an accurate diagnosis of this condition, especially before surgery.
CASE SUMMARY A 30-year-old man was admitted to the hospital because of a left epididymal mass with vague discomfort for more than 1 mo. A physical examination was performed, and the findings showed that the epididymal mass may have entered the abdominal cavity. Pelvic computed tomography was performed in our hospital and revealed a left inguinal hernia with a mass in the hernial contents, and no masses were found in the left epididymis. A traditional inguinal hernia incision was made. Intraoperative hernia contents were found to be of the greater omentum, and a 2.5 cm-diameter mass was found at the distal end of the greater omentum. The scrotum and epididymis did not exhibit other masses. Then, the mass of the greater omentum was excised. Intraoperative frozen pathological examination suggested a spindle cell tumor. The postoperative pathological examination suggested that the mass was an omental angiofibroma. Postoperatively, the patient recovered well and was discharged. Outpatient re-examinations were performed at 1 mo and half a year after the operation and showed no obvious abnormalities.
CONCLUSION Due to the low morbidity rate associated with and latent nature of omental tumors, these tumors are difficult to diagnose preoperatively; thorough medical history taking, detailed physical examinations, and necessary imaging auxiliary examinations can help clinicians diagnose and treat these cases.
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Affiliation(s)
- Jia-Yi Liu
- Department of Urology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China
| | - Shuai-Qi Li
- School of Medicine, Nankai University, Tianjin 300192, China
| | - Shi-Jie Yao
- Department of Urology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China
| | - Qian Liu
- Department of Urology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China
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McLaughlin J, Mahajan AB, Wang BG. A De Novo Case of Extranasopharyngeal Angiofibroma Resulting in Partial Airway Obstruction Contributing to Respiratory Failure in a 69-Year-Old Male. J Bronchology Interv Pulmonol 2021; 28:235-237. [PMID: 33758150 DOI: 10.1097/lbr.0000000000000769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Amit Bobby Mahajan
- Surgery, Inova Schar Cancer Institute, Inova Fairfax Hospital, Falls Church, VA
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L Ashworth H, K Flesner B, J Norquest C, A Maitz C. Nasal angiofibroma treatment outcome using intensity-modulated radiation therapy in a dog. Vet Radiol Ultrasound 2021; 62:e40-e43. [PMID: 33634903 DOI: 10.1111/vru.12961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/12/2021] [Accepted: 01/15/2021] [Indexed: 11/29/2022] Open
Abstract
A 6-year-old dog presented with a modified Adams stage 3 angiofibroma of the right nasal cavity, causing fluid accumulation along the right frontal sinus. Treatment consisted of step-and-shoot intensity-modulated radiation therapy in 12 daily treatments of 3.5 Gy, for a total dose of 42 Gy to 95% of the planning target volume. The dog developed self-limiting grade 2 oral mucositis which resolved within 2 weeks of course completion. A recheck exam 668 days after treatment confirmed a stable disease response by RECIST and a tumor volume decrease of 55.4%.
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Affiliation(s)
- Hayley L Ashworth
- University of Missouri Veterinary Health Center, Columbia, Missouri, USA
| | - Brian K Flesner
- University of Missouri Veterinary Health Center, Columbia, Missouri, USA
| | - Carissa J Norquest
- University of Missouri Veterinary Health Center, Columbia, Missouri, USA
| | - Charles A Maitz
- University of Missouri Veterinary Health Center, Columbia, Missouri, USA
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Capodiferro S, Limongelli L, D’Agostino S, Tempesta A, Dolci M, Maiorano E, Favia G. Diode Laser Management of Primary Extranasopharyngeal Angiofibroma Presenting as Maxillary Epulis: Report of a Case and Literature Review. Healthcare (Basel) 2021; 9:healthcare9010033. [PMID: 33401498 PMCID: PMC7824373 DOI: 10.3390/healthcare9010033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/24/2020] [Accepted: 12/29/2020] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Saverio Capodiferro
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70121 Bari, Italy; (S.C.); (L.L.); (A.T.); (G.F.)
| | - Luisa Limongelli
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70121 Bari, Italy; (S.C.); (L.L.); (A.T.); (G.F.)
| | - Silvia D’Agostino
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti Pescara, 66100 Chieti, Italy;
- Correspondence: ; Tel.: +39-3930246351
| | - Angela Tempesta
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70121 Bari, Italy; (S.C.); (L.L.); (A.T.); (G.F.)
| | - Marco Dolci
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti Pescara, 66100 Chieti, Italy;
| | - Eugenio Maiorano
- Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Gianfranco Favia
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70121 Bari, Italy; (S.C.); (L.L.); (A.T.); (G.F.)
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Kurien R, Mehan R, Varghese L, Telugu RB, Thomas M, Rupa V. Frontoethmoidal Extranasopharyngeal Angiofibroma With Orbital Pyocele. EAR, NOSE & THROAT JOURNAL 2020; 101:575-577. [PMID: 33226849 DOI: 10.1177/0145561320972600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Regi Kurien
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
| | - Raghav Mehan
- Department of Pathology, Christian Medical College, Vellore, India
| | - Lalee Varghese
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
| | | | - Meera Thomas
- Department of Pathology, Christian Medical College, Vellore, India
| | - Vedantam Rupa
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
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12
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Mandibular Intraosseous Angiofibroma-A Rare Clinical Entity. J Oral Maxillofac Surg 2020; 78:1343-1348. [PMID: 32360235 DOI: 10.1016/j.joms.2020.03.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 11/22/2022]
Abstract
Angiofibromas located in the maxillofacial region are rare and almost exclusively occur in adolescent males. These benign tumors are highly vascular, locally invasive, and commonly found in the nasopharyngeal space. In the present report, we describe a very rare case of an intraosseous mandibular angiofibroma in a 23-year-old male patient with histomorphologic and molecular confirmation. This type of tumor occurring in the mandible has been reported previously only once, to the best of our knowledge.
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Abstract
Angiofibroma is a rare tumor that accounts for about 0.05% of all head and neck tumors; it mainly occurs in the region of the nasopharynx. To date, no study originating in the frontal sinus has been reported. The authors report a report of an 18-year-old male complaining of severe pain in the right periocular area, forehead, and temporal area for 1 week. Endoscopic sinus surgery in combination with trephination was used to remove the tumor and the tumor was diagnosed as angiofibroma from histopathologic examination. It is hard to consider a tumor as being angiofibroma when it is not located in the nasopharynx. In particular, although extranasopharyngeal angiofibroma can occur in all head and neck regions, a tumor which has developed in the frontal sinus is more difficult to diagnose as angiofibroma because no patients have been reported until now. With this study, surgeons now need to be aware of the possibility of occurrence of angiofibroma in the frontal sinus.
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Kujundžić T, Perić A, Đurđević BV. Extranasopharyngeal Angiofibroma Arising from the Anterior Nasal Septum in a 35-Year-Old Woman. Craniomaxillofac Trauma Reconstr 2018; 12:141-145. [PMID: 31073364 DOI: 10.1055/s-0038-1675809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 09/27/2018] [Indexed: 10/27/2022] Open
Abstract
Angiofibroma is a relatively rare vascular lesion originating predominantly in the nasopharynx and occurs typically in male adolescents. Extranasopharyngeal sites of origin, such as nasal cavity, paranasal sinuses, pharynx, and larynx, are extremely rarely seen in clinical practice. In the nasal cavity, extranasopharyngeal angiofibromas (ENAs) have been reported to originate from the nasal septum, as well as from the middle and inferior turbinate. In this study, we report a case of a 35-year-old female patient with angiofibroma originating from the anterior part of the nasal septum with left-sided nasal obstruction and mild-to-moderate epistaxis as main complaints. After the radiological diagnostics and embolization of sphenopalatine artery, we performed the excision of the lesion with removal of small part of septal mucosa and perichondrium around the attachment of tumor pedicle. Histopathological examination suggested the presence of angiofibroma and diagnosis was confirmed by immunohistochemical analysis. This is the fifth reported case of septal ENA in female population in the English-language literature.
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Affiliation(s)
- Tarik Kujundžić
- Department of Otorhinolaryngology, Military Medical Academy School of Medicine, Belgrade, Serbia.,ENT Unit, General Hospital Pljevlja, Pljevlja, Montenegro
| | - Aleksandar Perić
- Department of Otorhinolaryngology, Military Medical Academy School of Medicine, Belgrade, Serbia
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Kim HD, Choi IS. Extranasopharyngeal angiofibroma mimicking choanal polyp in patients with chronic paranasal sinusitis. Auris Nasus Larynx 2018; 46:302-305. [PMID: 29954635 DOI: 10.1016/j.anl.2018.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 11/29/2022]
Abstract
Extranasopharyngeal angiofibroma (ENA) is an angiofibroma that occurs in the extranasopharynx. It shows pathologic findings, such as juvenile angiofibroma (JNA), which accounts for 0.5% of head and neck mass. However, compared with JNA, the prevalence, affected site, and clinical characteristics are completely different, which leads some physicians to classify ENA as a disease different from JNA. ENA of the nasal turbinate origin are rarely reported in the literature. In addition, choanal polyp originating from the posterior part of the nasal turbinate is uncommonly reported. Recently, we encountered two cases of ENA, which were not diagnosed by intraoperative frozen section examination, but were histopathologically diagnosed post-operatively. Although we were unable to diagnose and perform embolization pre-operatively, ENA has been successfully treated by endoscopic surgery, without profuse bleeding.
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Affiliation(s)
- Hae Dong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Ick Soo Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.
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