title: Extranasopharyngeal angiofibroma: clinical and radiological presentation.
abstract: Nasopharyngeal angiofibroma (NA) is a rare, vascular tumor affecting adolescent males. Due to aggressive local growth, skull base location and risk of profound hemorrhage, NA is a challenge for surgeons. Angiofibromas have been sporadically described in extanasopharyngeal locations. We review ten cases of extranasopharyngeal angiofibroma (ENA) and discuss the incidence, clinical presentation and management of this pathology. The group consisted of 4 males and 5 females aged 8-49. There were 7 patients with nasal angiofibroma, 1 patient with laryngeal angiofibroma, 1 patient with oral angiofibroma and another patient with infratemporal fossa tumor. In patients with nasal angiofibroma most common presenting symptoms were nasal obstruction and epistaxis. Patients with laryngeal angiofibroma suffered from mild dysphagia and patients with the infratemporal fossa tumor had painless cheek swelling. In four patients with nasal tumor computed tomography (CT) demonstrated mass with strong to intermediate contrast enhancement. In one patient with nasal tumor carotid angiography demonstrated pathological vessels without intensive tumor blush. Infratemporal fossa tumor showed intensive contrast enhancement on CT and magnetic resonance imaging (MRI) scans, and abundant vascularity on angiography. Laryngeal and oral angiofibroma required no radiological imaging. Three nasal tumors were evaluated before introduction of CT to clinical practice. All patients underwent surgery. No recurrences developed. ENAs differ significantly from NAs regarding clinical and radiological presentations. They lack typical clinical and radiological features as they develop in all age groups and in females, may be less vascularised, arise from various sites and produce a variety of symptoms.
authors.affiliation: Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Ul. Jaczewskiego 8, 20-954 Lublin, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Szymańska
authors.forename: Marcin
authors.initials: M
authors.lastname: Szymański
authors.forename: Kamal
authors.initials: K
authors.lastname: Morshed
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Czekajska-Chehab
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Szczerbo-Trojanowska
mesh_terms: D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000000981:diagnostic imaging* / Q000473:pathology*; D002610:Cheek; D002648:Child; D005153:Facial Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D014066:Palatine Tonsil; D011859:Radiography; D055815:Young Adult