The site of origin and expansive routes of juvenile nasopharyngeal angiofibroma (JNA)

Overt and occult vidian canal involvement in juvenile angiofibroma and its possible impact on recurrence

“…Contemporary concepts, however, indicate that the tumor may well involve the vidian canal primarily and may also take origin here. This is supported by the theory of the lesion being derived from first branchial arch remanants, and also the radiological evidence of involvement of the pterygoid canal being more frequent (100%) than involvement of the pterygopalatine fossa (93%) or the nasopharynx (89%) …”

“…This study corroborates an increasing recognition in the recent literature indicating to near universal involvement of the vidian canal/pterygoid base in juvenile angiofibroma. 12,13 A systemic review incorporating 257 cases from 1990 to 2012 noted the recognition of pterygopalatine fossa involvement in 48% and pterygoid canal involvement in only 0.4%, 14 a recent report by Liu et al 13 notes the radiological evidence of pterygoid canal involvement in 100% of the cases (46 of 46). This report, over a prospective and consecutive series, has again confirmed near universal involvement of the vidian canal.…”

“…This is supported by the theory of the lesion being derived from first branchial arch remanants, 7,8 and also the radiological evidence of involvement of the pterygoid canal being more frequent (100%) than involvement of the pterygopalatine fossa (93%) or the nasopharynx (89%). 13 It is additionally noted with contemporary radiology that tumor restricted to the nasopharynx/nasal cavity (Radkowski stage I) is almost never encountered, and perhaps a new classification system is required which recognizes this. This study has noted all cases to be Radkowski stage IIA and above.…”

Expression of vascular endothelial growth factor in Juvenile Angiofibroma

“…Juvenile Angiofibroma (JA) is an encapsulated vascular tumor involving the skull base and has a high propensity to involve the skull base foramina. Sphenopalatine foramen has been considered long as the site of origin of JA, but recent literature suggests the pterygoid canal (Vidian Canal) as the site of origin [1]. Being a highly vascular tumor it was proposed that JA may be a hemangioma [2], vascular malformation [3] or a remnant of the vascular plexus from the first arch branchial artery [4].…”

Tissue microarray analysis reveals that cofilin expression is a poor prognostic factor in juvenile nasopharyngeal angiofibroma

“…Juvenile nasopharyngeal angiofibroma (JNA) is a rare, highly vascularized tumor originating from the sphenopalatine foramen or pterygoid canal . JNA represents 0.05% of all head and neck tumors, and occurs primarily in adolescent males .…”