title: Bilateral juvenile nasopharyngeal angiofibroma: report of a case.
abstract: BACKGROUND
  Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign neoplasm of the nasopharynx. Almost always unilateral on diagnosis, JNAs are locally invasive and may extend across the midline, giving a false bilateral appearance; as such, true bilateral JNA is exceedingly rare. We present a recent case of true bilateral JNA.
  
  
  METHODS
  Single case report of a patient with bilateral JNA, including clinical presentation, diagnosis, and management.
  
  
  RESULTS
  The patient presented with unilateral nasal obstruction and recurrent epistaxis. Computed tomography and magnetic resonance imaging demonstrated bilateral, noncontiguous masses. Angiography revealed independent vascular supplies from each respective side with no bilateral supply noted. The patient underwent preoperative embolization followed by endoscopic surgical removal of the larger mass; no complications were noted. Follow-up at 2 years demonstrated no recurrence or growth.
  
  
  CONCLUSIONS
  The vast majority of JNAs are unilateral, though invasive growth to the contralateral side may appear "bilateral" in presentation. Proper identification of true bilateral JNA is helpful in guiding management, wherein excision of both tumors may not be necessary.
authors.affiliation: Department of Head and Neck Surgery, University of California, Los Angeles (UCLA) Medical Center, Los Angeles, CA.
authors.forename: Edward C
authors.initials: EC
authors.lastname: Wu
authors.forename: Davin W
authors.initials: DW
authors.lastname: Chark
authors.forename: Naveen D
authors.initials: ND
authors.lastname: Bhandarkar
mesh_terms: D000293:Adolescent; D018322:Angiofibroma / Q000175:diagnosis* / Q000601:surgery; D055088:Early Detection of Cancer; D004724:Endoscopy; D004844:Epistaxis / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015508:Nasal Obstruction / Q000175:diagnosis* / Q000601:surgery; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D009666:Nose / Q000473:pathology / Q000601:surgery; D010614:Pharynx / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: angiofibroma; bilateral; epistaxis; imaging; radiology