The Nature of Juvenile Nasopharyngeal Angiofibroma

Liang, Jiangang; Yi, Zixiang; Lianq, Ping

doi:10.1067/mhn.2000.105061

Cited by 46 publications

(36 citation statements)

References 11 publications

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“…The correlation between the young age and the recurrence rate has been shown in numerous studies [15,36,41], and tumour growth has been considered to be related with the hormonal environment during male puberty [40,[42][43][44]. In the present series it was also noted that only one patient out of nine patients over 17 years old had a recurrence.…”

Section: Discussionmentioning

confidence: 51%

The changing surgical management of juvenile nasopharyngeal angiofibroma

Renkonen

Hagström

Vuola

et al. 2010

Eur Arch Otorhinolaryngol

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The management of juvenile nasopharyngeal angiofibroma (JNA) has changed during the last decades but it still continues to be a challenge for the multidisciplinary head and neck surgical team. The aim of this study was to review the used treatment approach and outcome of JNA in a single institution series of 27 patients diagnosed and treated during the years 1970-2009. All patients were male, with the median age of 17 years (range 11-33 years). Surgery was used as the primary treatment in every case. Surgical approaches varied, transpalatal approach (N = 14) being the most common approach used in this series. During the last decade various other techniques were applied, including endoscopic (N = 3) resection. Two patients were additionally treated with antiangiogenic agents and one patient with stereotactic radiotherapy. The primary recurrence rate was 37% and it seemed to correlate with vascular density of tumour and the surgical approach used. We suggest that the management of JNA should be planned by an experienced head and neck surgeon, as part of a multidisciplinary team, preferably in a tertiary referral setting, and the recent development of the available therapies should be taken into account to minimise the risk of recurrence.

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Section: Discussionmentioning

confidence: 51%

The changing surgical management of juvenile nasopharyngeal angiofibroma

Renkonen

Hagström

Vuola

et al. 2010

Eur Arch Otorhinolaryngol

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“…Subsequently, Kumagami 21 used antibodies to steroid hormones to detect bound hormone in tissue sections and discovered evidence of bound estradiol and progesterone in 5/5, testosterone in 2/5, and dihydrotestosterone in 3/5 cases. Later, immunohistochemical studies were uniformly negative for ER, including a large series by Hwang et al 22 and Liang et al 23 These studies employed commercially available anti-ERa antibodies and, consequently, would be expected to fail to detect ERb. The antibody against ERb used in the current study was raised against a peptide sequence from the carboxy terminus of ERb, a region of the protein that lacks homology to the corresponding area of ERa.…”

Section: Discussionmentioning

confidence: 99%

Estrogen receptor β expression in vascular neoplasia: an analysis of 53 benign and malignant cases

et al. 2004

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The importance of estrogen in vascular neoplasia is suggested by a predilection for women and a tendency for rapid growth during pregnancy. Although early experiments using radioligand assays demonstrated estrogen receptor (ER) expression, these findings were not confirmed by subsequent immunohistochemical studies which were performed with antibodies raised against ERa. A newly discovered estrogen receptor subtype, ERb, has not been previously characterized in vascular lesions. In order to verify the expression of estrogen receptors in vascular neoplasms as well as to clarify the inconsistency between radioligand and early immunohistochemical studies, we examined a series of 53 benign and malignant vascular neoplasms for ERb expression. All of the subtypes of vascular neoplasia examined had nuclear expression of ERb. The majority of cases (94%) displayed 2 þ to 3 þ staining. The discrepancy between radioligand studies and previous immunohistochemical studies is attributable to the use of antibodies raised against ERa, which is not expressed in vascular lesions, and not ERb, which is broadly expressed in both benign and malignant vascular neoplasms. Although ERb may be of limited diagnostic use in vascular neoplasia due to its broad expression, the potential exists for a therapeutic approach using ER agonists. The role of estrogen in vascular neoplasia has long been suspected due to the observation that vascular neoplasms tend to grow rapidly during pregnancy and in adolescence. 1 These clinical observations were initially substantiated by early experiments in the 1980s using radioligand assays, which confirmed the presence of the estrogen receptor (ER) in vascular tumors; 2,3 however, with the advent of immunohistochemical techniques, subsequent studies performed in the 1990s with antibodies raised against the ER refuted these earlier data and it appeared that the newer technology had exposed the limitations of the older biochemical assays. [4][5][6][7] Recently, an additional ER subtype, estrogen receptor beta (ERb), 8 was identified and the previous ER against which the original antibodies were raised was renamed estrogen receptor alpha (ERa). Although ERa has been assessed immunohistochemically in vascular neoplasms and found to be absent, ERb has not been previously characterized in these entities. In order to verify the expression of ER in vascular tumors as well as to clarify the inconsistency between radioligand and early immunohistochemical studies, we examined a series of 53 benign and malignant vascular neoplasms for ERb expression. Materials and methodsIn all, 22 cases of angiosarcoma, three cases of Kaposi sarcoma, one case of epithelioid hemangioendothelioma, two cases of spindle-cell hemangioma, four cases of infantile hemangioendothelioma, 13 cases of hemangioma, seven cases of lymphangioma and one case of papillary endothelial hyperplasia were identified and retrieved from the paraffin archives of the University of Chicago. Formalin-fixed paraffin-embedded specimens were cut into 4-mm sections an...

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“…Pathologically, it is characterized by haphazardly arranged vascular channels surrounded by dense paucicellular fibrous tissue. The smaller vessels in the central portion of the lesion typically lack muscular elastic laminae and the absence of muscular coat contributes to the capacity for massive bleeding that occurs with JNA [3]. Although angiofibroma is histologically benign, it may act in an aggressive fashion characterized by recurrences that may extend into and destroy the adjacent bony structures.…”

Section: Introductionmentioning

confidence: 99%

Management of Juvenile Nasopharyngeal Angiofibroma: A Five Year Retrospective Study

Moorthy

Reddy

Qaiyum

et al. 2010

Indian J Otolaryngol Head Neck Surg

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Juvenile nasopharyngeal angiofibroma is a pathologically benign yet locally aggressive and destructive vascular lesion of head and neck region typically affecting adolescent boys. The present article is a retrospective study of surgically treated patients of juvenile nasopharyngeal angiofibroma over a period of 5 years. The study discusses about most common presenting complaints, correlation of preoperative radiological and intraoperative staging and factors affecting recurrence of juvenile nasopharyngeal angiofibroma.

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The Nature of Juvenile Nasopharyngeal Angiofibroma

Cited by 46 publications

References 11 publications

The changing surgical management of juvenile nasopharyngeal angiofibroma

The changing surgical management of juvenile nasopharyngeal angiofibroma

Estrogen receptor β expression in vascular neoplasia: an analysis of 53 benign and malignant cases

Management of Juvenile Nasopharyngeal Angiofibroma: A Five Year Retrospective Study

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