Infact hippocrates goes on to describe a polyp in the nose which weeped blood. Nasopharyngeal angiofibroma is a histologically benign but locally aggressive vascular tumor of the nasopharynx that arises from the superior margin of the sphenopalatine foramen and grows in the back of the nasal cavity. According to this classification, the angiofibroma is classified as type i when the tumor is restricted to the nasal cavity and the nasopharynx without bone. Pdf download for facial palsy following embolization of a juvenile. Jnas occur almost exclusively in the nasopharynx of adolescent. May 16, 2018 patterns of vascularization and surgical morbidity in juvenile nasopharyngeal angiofibroma. The pictures used in this presentation have been obtained from a number of sources. Juvenile nasopharyngeal angiofibroma has been documented since the time of hippocrates 4 bc. Nasopharyngeal angiofibroma in an elderly female patient. Juvenile nasopharyngeal angiofibroma jna is a rare, benign, highly vascular, and locally aggressive tumor that predominantly occurs in. Mar 07, 2020 it most commonly affects adolescent males and may grow into fissures of the. Sirolimus for the treatment of juvenile nasopharyngeal.
They often grow quickly during puberty, then slow down or stop growing entirely after adolescence. A juvenile nasopharyngeal angiofibroma jna is a noncancerous tumor made up of blood vessels that grow at the posterior aspect of the nose. Read presentation download presentation nasopharyngeal angiofibroma dr. Juvenile nasopharyngeal angiofibroma, a slow growing, highly vascular, and locally destructive tumor, tends to secondarily involve the orbit by direct extension. In addition to its usefulness in the diagnosis of this entity, arteriography also has therapeutic implications. Nasoangiofibroma youth is a highly vascularized tumor almost exclusively male adolescents presentation. General characteristics, management and outcomes of 11 cases of jna presented to our centre between 2000 till 2015 were studied and evaluated. Juvenile nasopharyngeal angiofibroma jna is a pathologically benign yet locally aggressive and destructive tumor that develops in the choana and nasopharynx. Nasopharyngeal angiofibroma, an angiographic evaluation. Pdf juvenile angiofibroma jna is a relatively uncommon, highly vascular and benign tumor that presents most commonly in. Juvenile angiofibroma is a rare benign lesion originating from the pterygopalatine fossa with distinctive epidemiologic features and growth patterns. Contrastenhanced ct scan is the most commonly used modality for imaging of juvenile nasopharyngeal angiofibroma jna.
Nasopharyngeal angiofibroma definition of nasopharyngeal. Nasopharyngeal angiofibroma is a relatively uncommon tumor of adolescence which is usually manifested by massive nosebleeds and nasal obstruction. We propose a system for staging nasopharyngeal angiofibromas based on clinical evaluation and computerized tomography. However, the extensions of the tumor seem to be independent, each one with distinct behavior. Radiotherapy is the treatment of choice for most patients. Nasopharyngeal angiofibroma an overview sciencedirect. Angiofibroma of soft tissue is a benign soft tissue tumor that is clinically and pathologically distinct from cellular angiofibroma see chapter 17 and nasopharyngeal angiofibroma see chapter 4. Involution of juvenile nasopharyngeal angiofibroma with. Though it is a benign tumor, it is locally invasive and can invade the nose, cheek, orbit. Adolescents and young adults between 14 and 25 years are affected, and there is a distinct male predominance. There are, however, potentially serious short and longterm complications associated with the use of radiotherapy in the. Update on the infratemporal fossa approaches to nasopharyngeal angiofibroma. Although considered the standard of care by most, an endoscopic approach may not be sufficient for extensive tumours, as exemplified by the current case of a young man presenting with the largest juvenile nasopharyngeal. Juvenile nasopharyngeal angiofibroma is a benign but locally invasive tumor accounting for.
Management of juvenile nasopharyngeal angiofibroma. Usually, the presenting symptom is a painless nasal obstruction or epistaxis. Ppt journal juvenile nasopharynx angiofibroma free download as powerpoint presentation. When a diagnosis of na is made in a female patient, caution is necessary to exclude the possibility of a. Ppt juvenile nasopharyngeal angiofibroma powerpoint.
Juvenile nasopharyngeal angiofibroma electronic journal of. Juvenile nasopharyngeal angiofibroma jna is a histologically benign yet locally aggressive vascular head and neck neoplasm. Nasopharyngeal fibroma is a relatively rare lesion, admissions for this to the head and neck service of the memorial hospital in new york for example, representing only 1 in 1500 cases. Juvenile nasopharyngeal angiofibroma symptoms diagnosis. Nasopharyngeal angiofibroma na primarily affects adolescent males. Between 1948 and 1975, we have seen 48 patients with nasopharyngeal angiofibroma. Historical treatment of jna has included embolization, surgical resection, and radiation.
Nov 01, 2004 nasal cavity, paranasal sinuses, nasopharynx nasopharyngeal angiofibroma. Recent reports have suggested that radiotherapy may be preferable to other forms of treatment of juvenile nasopharyngeal angiofibroma. Nasopharyngeal angiofibroma should be suspected in young men who present with huge nasopharyngeal mass and stridor even when there is no or minimal history of nasal bleeding. Alamgir hossain shemul 1 comment juvenile nasopharyngeal angiofibroma is a benign tumour consists of fibrous tissue with a variable proportion of vascular tissues occur in the nasopharynx of mainly prepubertal and adolescent male. Given its vascularity, prominent flow voids are seen on mri leading to a salt and pepper appearance. The juvenile nasopharyngeal angiofibroma has a characteristic growth in all directions from its origin. Tumour extension produces rhinosinusal symptoms and facial swelling.
Introduction nasopharyngeal angiofibroma is a histologically and biologically benign tumor with aggressive behavior due to its location and associated symptoms including significant epistaxis and nasal obstruction since then, several cases have been reported, all showing that endoscopic resection resulted in lower morbidity during the early stages of disease in this study, we. The process was diagnosed as a juvenile nasopharyngeal angiofibroma. Ppt journal juvenile nasopharynx angiofibroma radiation. In spite of two attempts at resection of the tumor and arterial embolization, the tumor progressed intracranially.
Typical signs are nasal and eustachian tube obstruction, adenoidal speech, and dysphagia. Introduction juvenile nasopharyngeal angiofibroma na occurs almost exclusively in males, but has also been documented in females, albeit infrequently 15. Juvenile nasopharyngeal angiofibroma jna is a rare, benign, highly vascular, and locally aggressive tumor that predominantly occurs in adolescent males. We report the case of a 17yearold male who presented in 1995 with a mass filling the left posterior nasal cavity. May, 2010 nasopharyngeal angiofibroma is an uncommon, benign, fibrovascular tumor which exhibits a distinct predilection for adolescent males and accounts for less than 1% of all head and neck neoplasms 1, 2. Juvenile nasopharyngeal angiofibroma jna is a locally aggressive benign vascular tumour exclusively amongst adolescence males. There are, however, potentially serious short and longterm complications associated with the use of radiotherapy in the head and neck. A sevenyear experience with patients with juvenile nasopharyngeal. Juvenile nasopharyngeal angiofibromas are a rare benign, but locally aggressive, vascular tumors that occur almost exclusively in young men on imaging, they present as a vividly enhancing softtissue masses centered on the sphenopalatine foramen. Common practice is to excise the tumor with open or endoscopic surgery. Cellular angiofibroma of the nasopharynx is very rare, and the.
Seven cases of juvenile nasopharyngeal angiofibroma were seen in the division of radiation oncology of the department of human oncology, university of wisconsin hospitals from 1961 to 1977. It is a rare, benign, vascular neoplasm that accounts for less than 0. For a discussion of this entity please refer to the parent article. It is an aggressive neoplasm and shows a propensity for destructive local spread often extending to the base of the skull and into the cranium. Only rare cases of nasopharyngeal angiofibroma in female patients. Nasopharyngeal angiofibroma introduction juvenile nasopharyngeal angiofibroma jna is a benign, but locally aggressive and extremely vascular head and neck neoplasm, occurring almost exclusively in the nasopharynx of adolescent males. Juvenile nasopharyngeal angiofibroma is an uncommon benign tumour of the nasopharynx which arises in the region of the sphenopalatine foramen and it grows insidiously invading surrounding structures. Jan 11, 2020 juvenile nasopharyngeal angiofibroma jna is a pathologically benign yet locally aggressive and destructive tumor that develops in the choana and nasopharynx.
Nasopharyngeal angiofibroma naf is a highly vascular, histologically benign, but sometimes locally aggressive tumor of the nasopharynx that occurs almost exclusively in males, usually between 10 and 20 years of age. From a series of 5 cases studied arteriographically, 2 will be reported in some detail to illustrate these points. If you have nasopharyngeal cancer or are close to someone who does, knowing what to expect can help you cope. Objectiveshypothesis to highlight the presentation and management of juvenile nasopharyngeal angiofibroma jna in prepubertal children. Surgical experience with nasopharyngeal angiofibroma jama. Nasopharynx tumor an overview sciencedirect topics. Juvenile nasopharyngeal angiofibroma in prepubertal males. Juvenile nasopharyngeal angiofibroma jna is a benign tumor of the nasopharynx composed of fibrous. A number of childhood conditions are characterized by angiofibromas, but the most common is tuberous sclerosis. Pdf update on the infratemporal fossa approaches to. Review article nasopharyngeal angiofibroma ashutosh hota s. Juvenile nasopharyngeal angiofibroma is the most common benign tumor of the nasopharynx with complaints of unilateral nasal obstruction and recurrent nosebleeds in the young male population. Nasopharyngeal angiofibroma symptoms aurora health care.
Although the exact pathogenesis of the tumour is not yet known, natural history and growth patterns can be predicted. Imaging in the diagnosis of juvenile nasopharyngeal angiofibroma. Here you can find out about nasopharyngeal cancer, including risk factors, symptoms, how its found, and how its treated. Juvenile nasopharyngeal angiofibroma jna is a rare benign tumor arising predominantly in the nasopharynx of adolescent males. Angiofibroma nasofaring juvenile free download as pdf file. It is a rare tumor, accounting for download powerpoint presentations on juvenile angiofibroma ppt. Staging of juvenile nasopharyngeal angiofibromas is performed with crosssectional imaging and relies on the identification of local tumor extent, and invasion of adjacent spaces. It was friedberg who first used the term angiofibroma in 1940. Juvenile nasopharyngeal angiofibromas staging radiology.
Juvenile nasopharyngeal angiofibroma journal of the belgian. If the inline pdf is not rendering correctly, you can download the pdf file here. Nasopharyngeal angiofibroma an overview sciencedirect topics. Juvenile nasopharyngeal angiofibroma jna is a histologically benign but.
It was first described by hippocrates in the 5 th century bc. Nasopharyngeal angiofibroma is a vascular benign tumor that affects young men, and surgery is the treatment of choice. There are many classification described although none is. Their use is purely for academic and teaching purposes. Jul 15, 2015 juvenile nasopharyngeal angiofibroma jna is a benign neoplasm of the nasopharynx. The tumor usually arises in puberty and is more common in boys than in girls. The typical patient is an adolescent male with a clinical history of recurrent epistaxis and nasal obstruction. Nasopharyngeal angiofibroma the journal of laryngology. The nasopharyngeal angiofibroma jama otolaryngologyhead. Juvenile nasopharyngeal angiofibroma is a pathologically benign yet locally aggressive and destructive vascular lesion of head and neck region typically affecting adolescent boys. Juvenile nasopharyngeal angiofibroma jna is a rare tumor that predominantly occurs in adolescent males, the average age of occurence. Study design retrospective study of 14 cases of jna resection at the department of otorhinolaryngology, university of innsbruck innsbruck. The management of juvenile nasopharyngeal angiofibroma has undergone a significant evolution, with more surgeons moving towards the minimal invasive endoscopic approaches.
Introduction uncommon, benign and extremely vascular tumour up to 0. Angiofibroma of soft tissue occurs over a wide age range and affects females twice as frequently as males. Several staging classification has been proposed, however fisch classification table 1. Owing to the vascularity of the tumor, incisional biopsy is not attempted. View enhanced pdf access article on wiley online library html view download pdf for offline viewing. Imaging in the diagnosis of juvenile nasopharyngeal. Juvenile nasopharyngeal angiofibroma a free powerpoint ppt presentation displayed as a flash slide show on id. Nasopharyngeal angiofibromas npas are benign but locally aggressive, highly cellular, and richly vascularized mesenchymal neoplasms that arise in the roof of the nose and nasopharynx in males. Typically, the tumor has its onset in childhood, the ages of the patients ranging from seven to nineteen years, although cases in patients up to fifty years of. Juvenile nasopharyngeal angiofibroma jna is an uncommon vascular tumor occurring almost exclusively in adolescent males. Find powerpoint presentations and slides using the power of, find free presentations research about juvenile angiofibroma ppt.
Pdf nasopharyngeal angiofibroma is a relatively rare benign, but locally aggresive tumor of the nasopharynx afflicting the adolescent males. Surgical management and outcome of juvenile nasopharyngeal. Despite being a benign tumor, it can be aggressively destructive in surrounding tissues and bones by acting locally. Further operative attempts were decided against, and the patient was followed with repeated computed tomographic scans. Sep 01, 2008 juvenile nasopharyngeal angiofibroma is a rare, benign tumor that occurs most often in adolescent males. Endoscopic excision of juvenile nasopharyngeal angiofibroma. Juvenile nasopharyngeal angiofibroma is a very rare, highly vascular, uncapsulated and locally invasive tumor. Nasopharyngeal angiofibroma purushothaman p k, ramakrishnan r, kiruthiga devi m department of ent, head and neck surgery, srm medical college hospital and research centre, srm university, srm nagar, potheri603203, kanchipuram district, tamilnadu, india abstract juvenile nasopharyngeal angiofibroma is a rare. Histologically, angiofibromas are characterized by fibrosis of the dermis and blood vessels.
It is an uncommon tumor that affects male adolescents almost exclusively, with a reported incidence of between 1 in 6000 and 1 in 60,000 otolaryngology patients and accounts for 0. Pdf nasopharyngeal angiofibromachanging trends in the. Nasopharyngeal angiofibroma naf, occurring mostly in young men, is a histologically benign. Pdf imaging in the diagnosis of juvenile nasopharyngeal. Endoscopic endonasal resection of juvenile nasopharyngeal. Although the use of nonsurgical therapies is described in the literature, surgery is currently considered the ideal treatment for. Surgical experience with nasopharyngeal angiofibroma. Intricate mixture of stellate and staghorn blood vessels with variable vessel wall thickness ranging from single layer of endothelium to variable smooth muscle coat.
Juvenile nasopharyngeal angiofibroma is a benign but locally invasive tumor accounting for about 0. Nasopharyngeal angiofibroma is a histologically and biologically benign tumor with. Angiofibroma is a pink, firm, 1 to 2mm domeshaped papule most commonly located over the nasal bridge and cheeks fig. Nasopharyngeal angiofibroma na is a rare, vascular tumor affecting adolescent males. It most commonly affects adolescent males because it is a hormonesensitive tumor. Nasopharyngeal angiofibroma changing trends in the management. The gold standard treatment method is the surgical excision of the tumor. Nasopharyngeal angiofibroma the medical post powerpoint. Plain radiographs no longer play a role in the workup of a suspected juvenile nasopharyngeal angiofibroma, however they may still be obtained in some instances during the assessment of nasal obstruction, or symptoms of sinus obstructions. Juvenile nasopharyngeal angiofibroma radiology reference. To highlight the presentation and management of juvenile nasopharyngeal angiofibroma jna in prepubertal children. Juvenile nasopharyngeal angiofibroma jna onset most commonly is in the second decade. Juvenile nasopharyngeal angiofibroma is a rare benign tumour of vascular origin found in adolescent males, originating around the sphenopalatine foramen.
If nasopharyngeal angiofibroma is suspected based on physical examination a smooth vascular submucosal mass in the posterior nasal cavity of an adolescent maleimaging studies such as ct or mri should be performed. A dose of 3,000 rads in three weeks leads to thrombosis, fibrosis, and tumor regression, although a latent period up. Endoscopic surgery has been used to excise tumors in their initial stages, when there is no evidence of residual or recurrent disease. Immunolocalization of activated transforming growth factor. The present article is a retrospective study of surgically treated patients of juvenile nasopharyngeal angiofibroma over a period of 5 years.
Juvenile nasopharyngeal angiofibroma is a rare, highly luiz a cr, romualdo s lt, fava a s. Twentythree patients with this pathologic diagnosis have been managed at the. Management of nasopharyngeal angiofibroma in a 72yearold male. Due to aggressive local growth, skull base location and risk of profound hemorrhage, na is a challenge for.
Pdf juvenile nasopharyngeal angiofibroma researchgate. Facial palsy following embolization of a juvenile nasopharyngeal. In 1906 chareau revived the interest in the study of juvenile nasopharyngeal angiofibroma. It most commonly affects adolescent males and may grow into fissures of the. The method of treatments and the end results are discussed. Juvenile nasopharyngeal angiofibroma jna jnas are wellvascularized benign lesions typically occurring in adolescent males.
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