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Sinonasal tumours
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Yujay Ramakrishnan, Shahzada Ahmed
The evaluation of patients with juvenile angiofibroma relies on diagnostic imaging. CT hallmarks include widening of the sphenopalatine foramen and pterygopalatine fossa, and anterior bowing of the posterior wall of maxilla. MRI typically reveals signal flow voids. The diagnosis is made radiologically; preoperative biopsy is not recommended due to the bleeding risk. Angiography providing information on the vascular supply of the tumour to assist surgical planning and providing a means by which to embolise the main feeding branches. The Pittsburgh staging system assesses two important tumour attributes: route of intracranial extension and extent of vascular supply from the internal carotid artery [25].
Tuberous sclerosis complex
Published in Electra Nicolaidou, Clio Dessinioti, Andreas D. Katsambas, Hypopigmentation, 2019
Vesna Pljakoska, Katerina Damevska, Natasa Teovska Mitrevska
Treatment options for facial angiofibroma could be topical mTOR inhibitors, and there are benefits from various laser surgeries (vascular and ablative), using sedation with minimum surgical risks. Continual therapy is necessary, because improvements are temporary.17
Paediatric epistaxis
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
A good history is key to determining whether epistaxis is idiopathic or secondary in nature. A detailed description of the nature of the bleeding (severity, frequency, duration, originating side) as well as asking targeted questions aimed at uncovering an undiagnosed bleeding disorder (unexplained bruising, prolonged bleeding, family history of bleeding disorder) are very important. Associated symptoms such as unilateral nasal obstruction, diplopia, facial swelling or headache are of particular importance, especially in the male adolescent cohort, as juvenile nasopharyngeal angiofibroma (JNA), although rare, can present with these symptoms.
Nasopharyngeal rhinosporidiosis with intracranial extension masquerading as juvenile angiofibroma: an unusual entity
Published in British Journal of Neurosurgery, 2022
Gautam Dutta, Ghanshyam D. Singhal, Daljit Singh, Hukum Singh, Arvind Kumar Srivastava, Anita Jagetia
For our case, the juvenile suffered from recurrent epistaxis, which is the typical clinical picture of JNA. On physical examination, the mass was located within the nasopharyngeal area which was friable having tendency to bleed. Therefore, the tentative clinical diagnosis was JNA considering the much greater frequency of angiofibroma compared to any other pathology for the age group. The angiographic finding suggested this was a hyper-vascular mass, and we obliterated the feeding vessels with embolization. With this typical clinical pictures and angiographic findings, we continued to favor the clinical diagnosis of JNA. Because surgical removal is the treatment of choice for juvenile angiofibroma, we performed surgical excision of the mass after embolization, without suspecting another diagnosis until the biopsy reports were obtained.
Bilateral juvenile nasopharyngeal angiofibroma: A rare case report
Published in Acta Oto-Laryngologica Case Reports, 2021
Marlinda Adham, Kartika Hajarani, Lisnawati Rachmadi, Indrati Suroyo
Occurring almost exclusively in adolescent males, juvenile nasopharyngeal angiofibroma is a benign fibrovascular tumour. The expression of sex hormone receptors helps explain its sex and age predilection. At present, preoperative embolization is recommended to minimize surgical blood loss. Surgery remains the standard of care. Both endoscopic and open approaches offer effective treatment of JNA with similar rates of recurrence. This case showed complete separate bilateral tumours with separate blood supply. Suspecting bilateral juvenile angiofibroma in patient with two non-contiguous mass in head and neck region is a must. Proper diagnosis of bilateral JNA is helpful in guiding management and lead to good results.
Cellular angiofibroma of the orbit
Published in Orbit, 2021
G.J. Hötte, R.M. Verdijk, M. Gardeniers, D. Paridaens
In conclusion, cellular angiofibroma is a benign mesenchymal tumor that deserves a place in the differential diagnosis of solid tumors in the orbit. Clinical and histopathological characteristics resemble those of cellular angiofibroma found elsewhere in the body.