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Case Reports: Unusual association of diseases/symptoms
‘Juvenile’ nasal angiofibroma presenting in adulthood
  1. Eoin F Cleere,
  2. Laura McLoughlin and
  3. Peter D Lacy
  1. Department of Otolaryngology—Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
  1. Correspondence to Dr Eoin F Cleere; eoincleere{at}rcsi.ie

Abstract

Juvenile nasopharyngeal angiofibromas (JNAs) are rare hyper vascular, benign tumours typically demonstrating a locally aggressive growth pattern. The cardinal presenting symptoms are unilateral nasal obstruction and recurrent, spontaneous epistaxis. Cases outside the adolescent male population are exceedingly rare and present a diagnostic challenge. We present the case of a man in his 30s referred to our tertiary skull base centre, presenting with left nasal obstruction. Examination showed left nasopharyngeal fullness without a discrete mass. Cross-sectional imaging detailed a 2.5×2.1×1.3 cm mass localised to his left sphenoid sinus with bony erosion. Due to the suspicion of malignancy, multidisciplinary consensus was to perform a diagnostic excisional biopsy and this revealed a JNA. He remains clinically well and asymptomatic following surgery. This case highlights the potential for subtle symptomatology in the presentation of these tumours and the challenge in diagnosing a JNA outside the adolescent male population.

  • Ear, nose and throat/otolaryngology
  • Radiology
  • Head and neck surgery

http://dx.doi.org/10.1136/bcr-2022-254391

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    Footnotes

    • Contributors EFC, LMcL and PDL were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. EFC and PDL performed the study conception and planning. EFC and LMcL collected and interpreted the relevant data and prepared the initial manuscript. This was overseen by PDL. EFC, LMcL and PDL revised the manuscript. EFC, LMcL and PDL gave final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.