Juvenile Nasopharyngeal Angiofibroma

Abstract

Juvenile nasopharyngeal angiofibroma procured the #3 position for ACF abnormalities for a number of factors, including its uncommon and unusual nature. It is a rare, highly vascular, locally invasive benign nasopharyngeal neoplasm occurring almost entirely in adolescent and young adult males displaying a distinct tendency for recurrence. JNAs have a general incidence of 1: 1,500,000.

Once again, our Classic Clue section starts us thinking about an adolescent male presenting with epistaxis who has an avidly enhancing, heterogeneous posterior nasal mass with MRI showing characteristic salt and pepper appearance from the presence of prominent flow voids. Pertinent plain film, CT, MRI, and angiographic imaging features are described. Characteristic findings include the Holman-Miller sign with archetypical anterior bowing of the posterior maxillary sinus wall. Most MRI sequences show characteristic salt and pepper appearances from the presence of prominent flow voids. JNAs often enlarge the Vidian canal and foramen rotundum. The Differential is less problematic for this entity when the patient falls into the usual age group. The Genetics and Associations section suggests an androgen receptor offers a potential explanation for this tumor’s predilection for males (e). Historic Highlights reveals Hippocrates described the tumor in the fifth century BC. Absolutely another board examination must know entity.