The role of diagnostic and interventional radiology in juvenile nasopharyngeal angiofibroma: A case report and literature review

Suroyo, Indrati; Budianto, Taufik

doi:10.1016/j.radcr.2020.04.017

Cited by 10 publications

(5 citation statements)

References 3 publications

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“…Moreover, the radiological exams usually cannot be completely diriment regarding the final diagnosis, because of the similar aspects of SFTs and other mesenchymal tumors [18][19][20][21][22].…”

Section: Discussionmentioning

confidence: 99%

A Case Report of a Solitary Fibrous Tumor of the Maxillary Sinus

Bartolomeo

Negrello

Pellacani

et al. 2021

Reports

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A solitary fibrous tumor (SFT) is a benign neoplasm, firstly described as a mesenchymal tumor of the pleura. Its incidence range in the head and neck region is about 5–27%, but only rarely does it affect paranasal sinuses. The differential diagnosis is challenging, owing to its erosive growth pattern and immuno-histochemical features. SFTs have an aggressive behavior and an important recurrence potential. Therefore, a radical surgical excision is the gold standard therapeutic procedure. A rare SFT originating from the right maxillary sinus is reported here. The 37-year-old patient presented to the outpatient clinic with a painful expansive lesion in the whole right maxillary region. The overlying skin was inflamed and the patient had no epistaxis episodes. The 1.5 dentary element tested negative for vitality; however, a puncture of the lesion led to a hematic spill and no purulent discharge. An endoscopic-guided biopsy was suggestive either of SFT or hemangioperictoma, excluding a malignant neoplasm. A multi-equipe surgical team was activated. The lesion was embolized in order to achieve a good hemostatic control and, after 48 h, the neoplasm was radically excised with a combined open and endoscopic approach. The patient was disease-free at 12-month radiological and clinical follow-up. Given the rarity of this lesion and the delicacy required in addressing head and neck neoplasms, we believe that the present case report might be of help in further understanding how to approach cranio-facial SFTs.

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Section: Discussionmentioning

confidence: 99%

A Case Report of a Solitary Fibrous Tumor of the Maxillary Sinus

Bartolomeo

Negrello

Pellacani

et al. 2021

Reports

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“…Erosi dan perluasan kanal vidian. 1,4-6,8, 13,18 Magnetic Resonance Imaging (MRI) lebih baik dalam menilai gambaran lesi dan penyebaran tumor, khususnya pada kasus yang melibatkan tumor intrakranial yang berbatasan dengan sinus kavernosus dan internal carotid artery (ICA) dan untuk evaluasi lanjutan tumor residual/tumor berulang. Tumor dapat menampilkan gambaran salt and pepper dengan komponen fibrosa tumor berwarna putih dan komponen vaskuler angimatosa berwarna gelap.…”

Section: Diagnosisunclassified

“…Tumor dapat menampilkan gambaran salt and pepper dengan komponen fibrosa tumor berwarna putih dan komponen vaskuler angimatosa berwarna gelap. 1,4-6,8, 13,18 Angiografi adalah metode terbaik dalam memberikan informasi suplai vascular mayor dan untuk embolisasi preoperatif, namun hal ini harus dilakukan 24-48 jam sebelum melakukan reseksi dengan embolisasi. Arterial mayor yang menyuplai tumor-tumor ini adalah ICA ipsilateral yang khas dengan pembuluh darah tambahan Ascending Pharyngeal Artery dan cabang-cabang ICA kavernosa atau sistem carotid eksternal kontralateral.…”

Section: Diagnosisunclassified

Juvenile Nasopharyngeal Angiofibroma

Nasution

2021

JIK

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Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumour affecting mostly adolescent and can be malignant because it’s aggressive, destructive, spread locally and often extends to the skull. The exact cause of JNA is unknown. JNA originates from the pterygopalatine fossa at the aperture of the pterygoid canal. Clinical symptoms include nasal obtruction, epistaxis and headaches. The diagnosis is based on anamnesia, physical and radiological examination. CT scan and MRI are the main modalities in detecting and determining tumour stage.

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“…With extension into the maxillary region, infratemporal fossa, and with an intracranial extension of both the tumor and associated vascular feeders, these lesions pose a considerable challenge [12][13][14][15]. In one series, the results for five patients treated with transarterial embolization with Onyx were compared to those for five patients treated with direct tumoral embolization [16].…”

Section: Introductionmentioning

confidence: 99%

Preoperative Embolization of Fisch Grades II–IVa Juvenile Nasopharyngeal Angiofibromas: Transarterial Embolization in the Age of Onyx

Vakharia

Lim²,

Waqas³

et al. 2021

Cureus

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The current mainstay treatment for juvenile nasopharyngeal angiofibromas (JNAs) is surgical resection, but embolization of primary feeding arteries through endovascular transarterial and direct tumoral puncture embolizations with various agents has been described. We describe a single institutional experience with JNA embolization utilizing Onyx (Medtronic, Dublin, Ireland). MethodsA retrospective records review was performed to identify patients who underwent embolization for devascularization of Fisch grades II-IVa JNA (tumor extension beyond the sphenopalatine region) before surgical resection between 2010 and 2019. Fluoroscopy time, grade, intraoperative blood loss, and clinical follow-up data were compiled. Tumor devascularization percentage was calculated using ImageJ software (public domain, BSD-2) by measuring the ratio of preoperative and postoperative embolization tracing. ResultsFive consecutive patients (ages 12-16 years [average 14 years]; all male) with JNAs underwent preoperative transarterial embolizations performed under general anesthesia. All patients presented with epistaxis; two also presented with headaches. Fisch grades were II in two patients, IIIa in two, and IVa in one. The patient with the grade IVa lesion underwent direct transtumoral puncture and Onyx embolization. The mean percentage of all tumor devascularizations postembolization was 86.0±9.7%. Complete resection 24-48 hours postembolization was obtained for grades II and IIIa lesions with <700 mL blood loss. No embolization-related complications and no clinical sequelae were present in the five cases after embolization. ConclusionIn our experience, Onyx embolization of JNAs was safely conducted with adequate tumor penetration beyond the sphenopalatine region through transarterial routes.

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The role of diagnostic and interventional radiology in juvenile nasopharyngeal angiofibroma: A case report and literature review

Cited by 10 publications

References 3 publications

A Case Report of a Solitary Fibrous Tumor of the Maxillary Sinus

A Case Report of a Solitary Fibrous Tumor of the Maxillary Sinus

Juvenile Nasopharyngeal Angiofibroma

Preoperative Embolization of Fisch Grades II–IVa Juvenile Nasopharyngeal Angiofibromas: Transarterial Embolization in the Age of Onyx

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