Fact-sheet: Juvenile angiofibroma
Updated on 08/04/2017 at 8:26 AM
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Definition
Most common hypervascular benign tumor of the nasopharynx. Locally aggressive.
Clinical features
Male adolescent.
Recurrent epistaxis.
Episodes of often unilateral nasal obstruction.
CT
Soft tissue mass widening the pterygopalatine fossa, intense and homogeneous enhancement.
Extension most often toward the posterior wall of the nasal cavity. Precise assessment of bone destruction.
MRI
Intermediate T1 signal.
Punctate hyposignal foci --> "flow voids" related to the hypervascular nature of the tumor.
Intense and homogeneous enhancement.
Extension into adjacent spaces, though poor assessment of bone destruction.
Vascular intervention
X-Ray Angiography with preoperative embolization to secure the procedure.
Hyperselective embolization after identification of dangerous anastomoses using microparticles or gelatin fragments.
Treatment by direct puncture through the nasal cavities and injection of glue or Onyx is possible.
Management
No biopsy! Risk of cataclysmic epistaxis!
Differential diagnosis
Bleeding septal polyp
Inverted papilloma
Hemangiopericytoma
Solitary fibrous tumor