title: Lymphoepithelial carcinoma of the nasal cavity mimicking juvenile angiofibroma.
abstract: Juvenile angiofibroma, nasopharyngeal carcinoma (NPC) and lymphoepithelial carcinoma of the nasal cavity (LEC NC) all could be found as a hyper-vascular mass in the nasopharynx area. Performing biopsy for histopathologic confirmation is necessary in the case of NPC or LEC NC but could be fatal in the case of angiofibroma. In our case, a 21-year-old male who was suffering from unilateral nasal stuffiness and frequent epistaxis had a mass with an easily bleeding tendency in his right nasal cavity. Juvenile angiofibroma was suspected by clinical and radiologic examinations. We performed preoperative angiography and the feeding vessel from the right internal maxillary artery was obliterated with polyvinyl alcohol nanoparticle. The mass was completely removed endoscopically, and there was profound hemorrhage in spite of the preoperative embolization. The mass turned out to be LEC NC by postoperative histopathologic examination. To avoid this misdiagnosis, the authors suggest that we should perform biopsy under rigid endoscopy 24h after angiographic embolization. If the result of frozen biopsy is juvenile angiofibroma, we could perform surgery another 24h later. If the result is nasopharyngeal carcinoma or LEC NC, we could avoid unnecessary surgical removal and perform radiotherapy. In terms of treatment strategies, we suggest endoscopic removal of gross tumor and postoperative combination of chemoradiotherapy as the more curative regimen with less complications related with radiotherapy.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon, Republic of Korea.
authors.forename: Young Hyo
authors.initials: YH
authors.lastname: Kim
authors.forename: Beom Joon
authors.initials: BJ
authors.lastname: Kim
authors.forename: Tae Young
authors.initials: TY
authors.lastname: Jang
mesh_terms: D000328:Adult; D018322:Angiofibroma / Q000150:complications / Q000175:diagnosis*; D002277:Carcinoma / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004844:Epistaxis / Q000209:etiology; D006801:Humans; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000150:complications / Q000175:diagnosis*