Grade IV Juvenile Nasopharyngeal Angiofibroma

Abstract

Juvenile nasopharyngeal angiofibroma is a benign slow-growing, locally aggressive vasoactive neoplasia. This is a relatively rare and sporadic tumor and accounts for about 0.5% of all head and neck tumors. The clinical features are unilateral epistaxis and nasal obstruction, occurring in more than 80% of patients. We present the case of a 21-year-old male student, who presented with posterior and anterior epistaxis, severe headache and right nasal obstruction. A contrast-enhanced tomography of the sinuses was performed and a mass of nasosinusal soft tissue was visualized, occupying the nasal and cavity, sphenoidal and ethmoidal sinuses and postcontrast ipsilateral pterygopalatine fossa with vascular reinforcement and areas of necrosis was observed. The patient underwent surgery and had a satisfactory outcome. Through the presentation of this clinical case the clinical manifestations and the management of this entity are disclosed, since, being benign it can end up compromising life by excessive bleeding or intracranial extension.

Key words: nasopharyngeal angiofibroma, benign, aggressive, recurrent epistaxis, unilateral nasal obstruction