Juvenile Nasopharyngeal Angiofibroma: From Diagnosis to Surgical Approach

Abstract

Juvenile Nasopharyngeal Angiofibroma (JNA) is a rare benign tumor with primary involvement of the nasopharynx in 98% of cases. It is responsible for 0.5% of tumors of the head and neck, occurring in 1/150,000 individuals. Patients between 14 and 25 years old are particularly affected, with a predominance almost exclusively of males. Despite having a benign nature, AFJ has the potential to grow and involve neighboring structures, which highlights the importance of an attempted diagnosis and therapeutic intervention. This work serves to make a JNA theoretical review and present an endoscopic resection video of a JNA in a young male after a pre-op embolization of the tumour, which was essential for the success of the surgical intervention. JNA is an aggressive and locally invasive tumor that can recur after surgery, so an early diagnosis, adequate staging and the appropriate therapeutic plan are essential for the resolution of the clinical situation.

A Rare Association of Pituitary Macroadenoma With Nasopharyngeal Angiofibroma: A Case Report

“…Nasopharyngeal angiofibroma is an extremely vascular lesion and may have one or more than that arterial vascular pedicles [ 5 ]. It is usually mentioned as juvenile nasopharyngeal angiofibroma (JNA), angiofibromatous or fibromatous hamartoma of the nasal cavity or juvenile angiofibroma (JAF) [ 6 ]. The internal maxillary artery provides the primary arterial supply followed by the ascending pharyngeal artery, both being branches of the external carotid artery, accessory meningeal, middle meningeal and facial artery branches are the additional accessory arteries supplying the growth.…”

“…The etiopathogenesis of the tumor is not entirely understood but, as a majority of the patients with nasopharyngeal angiofibroma are males, hence high androgen receptor (AR) expression can be elucidated, suggesting that JNA is androgen dependent. Furthermore, vascular and hamartoma malformation theories are also suggested as once the JNA histologic origin involves endothelial cells or fibroblasts [ 6 ]. The co-occurrence of nasopharyngeal angiofibroma and pituitary macroadenoma is rare and can present unique diagnostic and treatment challenges.…”