Juvenile nasopharyngeal angiofibromas (JNA) are a rare benign but locally aggressive vascular tumor. Epidemiology Juvenile nasopharyngeal angiofibromas. Juvenile angiofibroma (JNA) is a benign tumor that tends to bleed and occurs in the nasopharynx of prepubertal and adolescent males. Home» Acta Otorrinolaringológica Española» Comprar Tratamiento quirúrgico del angiofibroma nasofaríngeo juvenil en pacientes pediátricos.
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They account for only 0. The presentation is typically with obstructive symptoms, epistaxisand chronic otomastoiditis due to obstruction of the Eustachian tube.
Patients may present with life-threatening epistaxis. On examination, it may be seen juvfnil a pale reddish-blue mass. It is, as the name suggests, very vascular and a biopsy can sometimes be fatal. Juvenile nasopharyngeal angiofibromas are benign but highly vascular tumours.
They may be locally aggressive.
The exact site of origin is contentious as these masses usually present when they have reached considerable size. However, most authors agree that JNAs arise from the posterior choanal tissues in the region of the sphenopalatine foramen. See staging of juvenile nasopharyngeal angiofibromas. Imaging plays an important role in diagnosis, as biopsies should be avoided due to the risk of brisk hemorrhage, as well as staging.
Although these masses are thought to arise from the region of the sphenopalatine foramenthey are usually sizeable at diagnosis, frequently with extension medially into the nasopharynxlaterally into the pterygopalatine fossa and over time beyond, into the orbitparanasal sinusesintracranial cavity and infratemporal fossa.
Plain radiographs no longer play a role in the workup of a suspected juvenile nasopharyngeal angiofibroma, however they may still be obtained in some instances during the assessment of nasal obstruction, or symptoms of sinus obstructions.
CT is particularly useful at delineating bony changes.
Pathology Outlines – Nasopharyngeal angiofibroma
Findings are similar to those described above. Typically a lobulated non-encapsulated soft tissue mass is demonstrated centred on the sphenopalatine foramen which is often widened and usually bowing the posterior wall of the maxillary antrum anteriorly. There is marked contrast enhancement following administration of contrast, reflecting the prominent vascularity.
Extensive bony destruction is usually not a feature, but rather bone is remodelled or resorbed. This feature may be helpful is differentiating from other more aggressive lesions.
Nasopharyngeal angiofibroma: Our experience and literature review
Intracranial extension can however occur. Angiography, although not essential, is often useful in nasofarnfeo defining the naeofarngeo vessels as well as in preoperative embolisation. Supply of these tumours is usually via The presence of prominent flow voids lead to a salt and pepper appearance on most sequences and are characteristic 5,6. Surgical resection either open or increasingly endoscopic is the treatment of choice, usually performed with pre-operative embolisation to help with haemostasis.
Irradiation may be an option if surgery is not possible or only incomplete resection achieved 2,4,6. You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Unable to process the form. Check for errors and try again. Thank you for updating your details. Log in Sign up. Articles Cases Jyvenil Quiz.
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