Juvenile Nasopharyngeal Angiofibroma

Watters, Karen; McGill, Trevor J.; Rahbar, Reza

doi:10.1007/978-1-4614-8755-5_25

Cited by 1 publication

(1 citation statement)

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“…21,22 Biopsy is usually not performed prior to embolization and definitive JNA surgical resection due to the vascular nature of this lesion and the potential for resultant severe hemorrhage. 23 In the vast majority of JNA cases, the diagnosis is strongly suspected based upon the age of the patient, clinical presentation, and imaging features. However, in this atypical younger age group with variable clinical presentation and absence of pathognomonic imaging findings, biopsy may be indicated.…”

Section: Discussionmentioning

confidence: 99%

Juvenile nasopharyngeal angiofibroma in prepubertal males: A diagnostic dilemma

et al. 2018

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Objectives/Hypothesis To highlight the presentation and management of juvenile nasopharyngeal angiofibroma (JNA) in prepubertal children. Study Design Single‐institution 10‐year retrospective review. Methods All identified cases of pathologically confirmed JNA in children <10 years of age were assessed from a gender, imaging and embolization findings, tumor stage, surgical approach, and clinical outcomes standpoint, and compared to a group of stage‐matched older patients from the same time period. Results Of 45 patients over the 10‐year study period, four male children between 8 to 9.8 years of age were identified. One patient had University of Pittsburgh Medical Center stage 1 disease, and the other three had stage 3 disease at presentation. A malignant process other than JNA was of concern preoperatively in two of the four children due to a combination of aggressive imaging characteristics and an absence of pterygopalatine fossa involvement. Such pterygopalatine fossa involvement was comparatively uniformly present in a group of stage‐matched JNA patients aged 15 to 21 years. All four prepubescent children underwent surgical resection via transnasal endoscopic approach following ipsilateral sphenopalatine artery embolization without the need for blood transfusion. There were no recurrences in three of the four cases at a median follow‐up duration of 2.3 years (range, 0.8–6.4 years). Conclusions JNA may pose a diagnostic challenge in prepubertal males due to the atypical age at presentation and absence of classic imaging characteristics. Successful endoscopic transnasal resection is possible despite anatomic constrictions. Level of Evidence 4 Laryngoscope, 129:1777–1783, 2019

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Section: Discussionmentioning

confidence: 99%