Ppt journal juvenile nasopharynx angiofibroma free download as powerpoint presentation. Review article nasopharyngeal angiofibroma ashutosh hota s. The development of minimally invasive techniques has led to the increased use of endoscopic surgery for the treatment of nasopharyngeal angiofibroma 21making it ideal for angioribroma confined to the nasopharynx, nasal cavity, and sphenoid sinus with minimal extension into the pterygopalatine fossa 10 12 15 18 all the contents of this journal, except where. Accordingly, we studied patients with this lesion seen at the princess margaret hospital, toronto, in order to draw conclusions about these inconsistencies and reported our findings in 1967 and 1970 6,7. Juvenile nasopharyngeal angiofibroma jna is a rare tumor that predominantly occurs in adolescent males, the average age of occurence being 15. Preoperative embolization is also important to reduce intraoperative blood loss. Do not attempt selfremoval of angiofibromas as that can often lead to permanent scars. Nasopharyngeal angiofibromas are rare vascular tumours seen in ent practice.
Reddy ka, mendenhall wm, amdur rj, stringer sp, cassisi nj. Jul 15, 2015 juvenile nasopharyngeal angiofibroma jna is a benign neoplasm of the nasopharynx. A rare case initially diagnosed as nasopharyngeal angiofibroma in an old patient and later diagnosed as pseudotumor by the careful histological and clinical observation was reported. The juvenile nasopharyngeal angiofibroma jna is a highly nasoangiofibroma youth is a highly vascularized tumor almost exclusively male. Juvenile nasopharyngeal angiofibroma radiology case. Juvenile nasopharyngeal angiofibroma linkedin slideshare. We report the case of a 17yearold male who presented in 1995 with a mass filling the left posterior nasal cavity. Extension to intracranial cavity is not uncommon and presents difficulties in management. In addition, the term nasopharyngeal is often used instead of nasal because angiofibromas that occur.
Ppt juvenile nasopharyngeal angiofibroma powerpoint. Juvenile nasopharyngeal angiofibromas jna are a rare benign, but locally aggressive, vascular tumor. It is not as invasive as to surgery that is almost free of acute complications in. Juvenile nasopharyngeal angiofibroma with audio youtube. This is a histologically benign lesion with very aggressive local behavior. Frequently, the term juvenile is not included in the name of this tumor because this lesion may occur in adults occasionally, as well as in adolescents. Pdf download for facial palsy following embolization of a juvenile. The biopsy showed thin walled and angulated blood vessels and the blood vessels were lined by a single layer of endothelial cells and showed an incomplete muscular wall which was suggestive of nasopharyngeal angiofibroma fig.
Nasopharyngeal angiofibroma symptoms aurora health care. Pdf juvenile nasopharyngeal angiofibroma researchgate. Sep 01, 2008 juvenile nasopharyngeal angiofibroma is a rare, benign tumor that occurs most often in adolescent males. It is almost exclusicely encountered in adolescent males 1. Extranasopharyngeal angiofibromas ena arising exclusively from the nasal septum, nasal septal angiofibromas nsa, are extremely rare with only cases to date. Common practice is to excise the tumor with open or endoscopic surgery. This is a concise presentation for medical students especially from india. Nasopharyngeal angiofibroma and cancer shyni dharipelly. Mean age at diagnosis is 14 years may regress in late teens but may persist into adulthood rare in patients older than 25 years. Nasopharyngeal angiofibroma naf is a highly vascular, histologically benign, but sometimes locally aggressive tumor of the nasopharynx that occurs almost exclusively in males, usually between 10 and 20 years of age. Hunt, in diagnostic immunohistochemistry third edition, 2011.
Pdf nasopharyngeal angiofibroma staging and selecting a. Accordingly, we studied patients with this lesion seen at the princess margaret hospital, toronto, in order to draw conclusions about these inconsistencies and. Juvenile nasal angiofibroma jna is a rare sinonasal tumor that is found almost exclusively in adolescent and young adult males. Juvenile nasopharyngeal angiofibroma is a benign but locally invasive tumor accounting for about 0. Juvenile nasopharyngeal angiofibroma jna onset most commonly is in the second decade.
A juvenile nasopharyngeal angiofibroma jna is a noncancerous tumor made up of blood vessels that grow at the posterior aspect of the nose. The endoscopic resection is best indicated for small tumors confined to the nasopharynx, nasal cavity, ethmoid and sphenoid, and in some cases, tumors with extension into the pterygopalatine fossa 4. Juvenile nasopharyngeal angiofibroma knowledge for medical. Juvenile nasopharyngeal angiofibroma has been documented since the time of hippocrates 4 bc.
Juvenile nasopharyngeal angiofibromas staging dr jeremy jones and assoc prof frank gaillard et al. Well circumscribed, variable pseudocapsule cellular tumor with fascicles or haphazard pattern. Juvenile nasopharyngeal angiofibroma jna jnas are wellvascularized benign lesions typically occurring in adolescent males. Juvenile nasopharyngeal angiofibroma knowledge for. Interphase fish on cut sections from nine additional cases of soft tissue angiofibroma using pools of bacs covering ahrr and ncoa2 yielded fusion signals in at least 10% of the nuclei in three cases. Angiofibroma removal in toronto dermatology centre is a commonly performed procedure with great results. They often grow quickly during puberty, then slow down or stop growing entirely after adolescence. Juvenile nasopharyngeal angiofibroma jna is a benign neoplasm of the nasopharynx. Juvenile nasopharyngeal angiofibroma for medical students. Nasopharyngeal angiofibroma is a histologically benign but locally aggressive vascular tumor of the nasopharynx that arises from the superior margin of the sphenopalatine foramen and grows in the back of the nasal cavity.
Juvenile nasopharyngeal angiofibroma is a pathologically benign yet locally aggressive and destructive vascular lesion of head and neck region typically affecting adolescent boys. May, 2010 the preoperative diagnosis of nasopharyngeal angiofibroma can be a challenging task. This is a concise presentation for medical students especially from. Toronto dermatology centre is located in toronto, ontario, and serves men and women in north york, vaughan, richmond hill, york, aurora. In fact, biopsy prior to definitive treatment is generally condemned as both unnecessary and hazardous. There are many classification described although none is.
Angiofibroma nasofaring juvenile free download as pdf file. Juvenile nasopharyngeal angiofibroma radiology reference. Pdf nasopharyngeal angiofibroma update on etiology. Jan 11, 2011 juvenile nasopharyngeal angiofibroma is a pathologically benign yet locally aggressive and destructive vascular lesion of head and neck region typically affecting adolescent boys. Juvenile nasopharyngeal angiofibromas staging radiology. It is not as invasive as to surgery that is almost free of. Denker operation is an effective surgical approach in managing. Nasopharyngeal angiofibroma is an uncommon, benign, fibrovascular tumor which exhibits a distinct predilection for adolescent males and accounts for less than 1% of all head and neck neoplasms 1, 2. Even in patients who received preoperative embolization, a bloodfree surgical field may not be obtained because of collaterals and variable origin of the vidian.
It is the most common benign tumor of the nasopharnyx but only accounts for less than 0. Fortythree cases of jna were treated at our institution from 1975 to 1999. Infact hippocrates goes on to describe a polyp in the nose which weeped blood. Ten patients were adolescent males, 2 were females. The aim of this retrospective study was to compare clinical and radiological findings and discuss optimal surgical approach in patients with juvenile nasopharyngeal angiofibroma jna. Though it is a benign tumor, it is locally invasive and can invade the nose, cheek, orbit.
Juvenile nasopharyngeal angiofibroma is a pathologically benign yet locally aggressive and destructive vascular lesion of head and neck. Jnas originate from the posterior choanal tissues and rapidly extend into the surrounding regions, including the nasopharynx, the orbits, and even the intracranial cavity. Angiofibromas are small, reddish brown or even fleshcolored, smooth, shiny, 0. Juvenile nasopharyngeal angiofibroma is a highly vascularized tumor found almost exclusively in adolescent males and it arises in the majority of the cases from the. Juvenile nasopharyngeal angiofibroma romanian journal of. Although the clinical presentation of these tumors differs vastly from the classically described juvenile nasopharyngeal angiofibroma jna, the histopathology is similar.
Longterm results of radiation therapy for juvenile nasopharyngeal angiofibroma. Nasopharyngeal angiofibroma an overview sciencedirect. The vascular component of the lesion is prone to bleeding and responsible for its clinical malignancy. Juvenile nasopharyngeal angiofibroma jna is a histologically benign, but locally.
It was first described by hippocrates, a greek physician, in the 5th century bc. Twelve cases of angiofibromata of the nasopharynx are described. At the same time, it is the most common benign neoplasm of the nasopharynx. As the tumor is largely spaceoccupying and highly vascular, patients typically. Introduction uncommon, benign and extremely vascular tumour up to 0. Diagnosis and treatment of juvenile nasopharyngeal angiofibroma. Radiotherapy of nasopharyngeal angiofibroma springerlink. Article information, pdf download for denker operation is an effective surgical approach in.
In 1906 chareau revived the interest in the study of juvenile nasopharyngeal angiofibroma. Nasopharyngeal angiofibroma is a benign, vascular, polypoid fibrous mass in located in the the posterolateral wall of the nasal cavity. Juvenile nasopharyngeal angiofibroma is a rare, benign tumor that occurs most often in adolescent males. Juvenile nasopharyngeal angiofibroma jna is a relatively rare tumor occurring mainly in adolescent boys. Diagnosis and treatment of juvenile nasopharyngeal. Nasopharyngeal angiofibroma may be classified according to. Given the strict epidemiology, hormonal influences seem likely as investigators have revealed the presence of androgen, testosterone, and dihydrotestosterone receptors 3, 4 and. Review article nasopharyngeal angiofibroma ashutosh hota. The present article is a retrospective study of surgically treated patients of juvenile nasopharyngeal angiofibroma over a period of 5 years. This is a classical presentation of juvenile nasopharyngeal angiofibroma. It invades the natural foramina and fissures usually present in the. Epidemiology juvenile nasopharyngeal angiofibromas. The most common presenting symptom is painless nasal obstruction or epistaxis. In this video, we are going to see about juvenile nasopharyngeal angiofibroma.
Ppt journal juvenile nasopharynx angiofibroma radiation. Juvenile angiofibroma is a rare benign lesion originating from the pterygopalatine. Another case of recurring nasopharyngeal angiofibroma with lateral extension to peterygomaxillary fossa and cheek removed successfully by transpalatal and. The juvenile nasopharyngeal angiofibroma has a characteristic growth in all directions from its origin. Additional interphase fish using a breakapart probe for the ncoa2 gene in the six fusionnegative cases did not reveal any split signals. May 15, 2012 nasopharyngeal angiofibroma na is a rare, vascular tumor affecting adolescent males.
Review of the literature on the rare nasopharyngeal angiofibroma reveals a number of inconsistencies in the tumors spectrum, its behaviour and its response to treatment 15. Juvenile nasopharyngeal angiofibroma is a locally aggressive benign vascular neoplasm, composed of vasogenic and myofibroblastic elements, accounts for 0. Hippocrates described this tumor in the 5 th century bc, but friedberg first used the term angiofibroma in 1940. Seven cases of nasopharyngeal angiofibroma treated surgically have been reported. The mass was free from septum, lateral wall and floor and was seen to be arising from the. Intricate mixture of stellate and staghorn blood vessels with variable vessel wall thickness ranging from single layer of endothelium to variable smooth muscle coat. Thirtythree male patients aged between 8 and 25 years mean 15.
These features are compatible with juvenile angiofibroma, a benign but locally invasive tumor. Juvenile nasopharyngeal angiofibroma electronic journal of. Management of juvenile nasopharyngeal angiofibroma. We had recently a case of an extensive jna in the r nasal cavity extending from the anterior nares to the nasopha. Although a histopathologically benign tumor of vascular origin, jna behaves locally invasive and. Nasal septal angiofibroma, a subclass of extranasopharyngeal. Juvenile nasopharyngeal angiofibromas occur almost exclusively in males and usually in adolescence 15 years. Nasopharyngeal angiofibroma na is a rare vascular tumor, which represents 0. Adolescents and young adults between 14 and 25 years are affected, and there is a distinct male predominance.
Nasopharyngeal angiofibroma update on etiology, diagnosis, and management. Staging of juvenile nasopharyngeal angiofibromas is performed with crosssectional imaging and relies on the identification of local tumor extent, and invasion of adjacent spaces. Nasoangiofibroma youth is a highly vascularized tumor almost exclusively male adolescents presentation. Nasopharyngeal angiofibroma is a histologically benign tumor composed of stroma and vessels. It is crucial to recognize these tumors on imaging as a biopsy can be disastrous due to their high vascularity. Patients usually present with nasal obstruction and epistaxis. The angiofibroma right abuts normal sinonasal respiratory mucosa left, supporting an extrapharyngeal location. Juvenile nasopharyngeal angiofibroma 420 introduction juvenile nasopharyngeal angiofibroma jna represents 0.
Surgical experience with juvenile nasopharyngeal angiofibroma. Well circumscribed but unencapsulated polypoid fibrous mass, bleeds severely on manipulation and biopsy, may occlude nares. Nasopharyngeal angiofibroma introduction juvenile nasopharyngeal angiofibroma jna is a benign, but locally aggressive and extremely vascular head and neck neoplasm, occurring almost exclusively in the nasopharynx of adolescent males. Call 4166330001 or email us today to find out the best angiofibroma treatment option for you. It most commonly affects adolescent males and may grow into fissures of the. Juvenile nasopharyngeal angiofibroma jna is a relatively rare tumor with an incidence of between 1. Facial palsy following embolization of a juvenile nasopharyngeal. For a discussion of this entity please refer to the parent article. The nasopharyngeal component with submucosal spread is clearly evident black asterisk. Juvenile nasopharyngeal angiofibroma is a benign, locally aggressive, vascular tumour of adolescent males. In the other type the vascular channels are made up. Due to aggressive local growth, skull base location and risk of profound hemorrhage, na is a challenge for surgeons. The diagnosis is predicated upon appropriate clinical history and the highly characteristic radiographic appearance.
They are exclusively found in males and if diagnosed in a female patient, genetic testing. However, this case is not typical as it doesnt invade the nasal fossae. Nasopharyngeal angiofibroma an overview sciencedirect topics. However, the extensions of the tumor seem to be independent, each one with distinct behavior. Juvenile nasopharyngeal angiofibroma with orbital extension. It most commonly affects adolescent males because it is a hormonesensitive tumor. A 60yearold male who had a longstanding history of chronic sinusitis was found having anasopharyngeal tumor in the right nasal cavity and an ossified polyp in. Juvenile nasopharyngeal angiofibromas jna are a rare benign but locally aggressive vascular tumor.
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