Extranasopharyngeal Angiofibroma of the Larynx

Abstract

Objective: To present a rare case of laryngeal extranasopharyngeal angiofibroma, discussing its diagnosis, treatment and differences from the more typical juvenile angiofibroma. Methods:Design: Case Report Setting: Tertiary Government Hospital Patient: OneResults: A 51-year-old male with a two-year history of hoarseness developed difficulty of breathing. Direct laryngoscopy showed a 2x2x1cm glistening, multinodular, pedunculated, firm, pink mass attached to the posterior half of the right true vocal fold obstructing the glottic opening and extending superiorly to the ventricle. Microlaryngeal excision was done. Histopathology showing numerous vascular channels surrounded by dense paucicellular fibrous tissue was consistent with angiofibroma. Conclusion:Primary extranasopharyngeal angiofibroma is rare, with only four previously reported cases occurring in the larynx. We presented what may possibly be the first locally reported case. Although histopathologically similar to the more common juvenile nasopharyngeal angiofibroma, this was atypically seen in the larynx of an older adult patient. Direct laryngoscopy provided excellent exposure for identification as well as complete surgical resection. Unlike the nasopharyngeal type, no massive bleeding was encountered. Prognosis for this extranasopharyngeal angiofibroma is excellent as recurrence is noted to be rare, however, long term follow-up is recommended.

Extranasopharyngeal Angiofibroma: A Diagnostic Dilemma

“…7 Other primary extra-nasopharyngeal sites reported are ethmoid and sphenoid sinuses, nasal septum, frontal recess, middle and inferior turbinates, tonsil, parapharyngeal space, ear, trachea, larynx, middle cranial fossa, infratemporal fossa, tonsil, retromolar region and conjunctiva. 8 Trinidad et al have reported a case of extranasal angiofibroma arising from the vocal cord. 8 In our cases the mass was seen arising from the posterior septum and oropharynx, respectively.…”

“…8 Trinidad et al have reported a case of extranasal angiofibroma arising from the vocal cord. 8 In our cases the mass was seen arising from the posterior septum and oropharynx, respectively. To the best of our knowledge, based on a search of the English literature in MEDLINE(PubMed), EMBASE, Scopus and Google Scholar using the keywords "angiofibroma, " "extranasopharyngeal angiofibroma, " "juvenile angiofibroma, " "atypical angiofibroma, " we could not find no other reports of an angiofibroma arising from the soft palate and uvula.…”