Juvenile nasopharyngeal angiofibroma ivanand B BagewadK : -Professor and . Head. ^Associate! fppslgraduate student. DepartmentjOf Ora^weaione SJadtotogy,. JSS Dental Bofcge and Hospttat.SS Nagar, iMysore'£70015. "Correspond rng
[email protected] Ind JDent Res 16(1): 22-26,2005
ABSTRACT Juvenile nasopharyngeal angiofibroma is a rare, histologically benign yet locally aggressive, vascular tumor that typically affects adolescent males. It accounts for 0.5 percent of all neoplasms of the head and neck. A case of juvenile nasopharyngeal angiofibroma manifesting in the oral cavity in a 20-year-old male patient is presented and discussed. Key words: Nasopharyngeal angiofibroma, Juvenile. Angiography
INTRODUCTION Juvenile nasopharyngeai angiofibroma is a rare vascular and fibrous tumor-like lesion that occurs only in nasopharynx (1). It rarely involves the oral cavity causing palatal expansion or inferior displacement of the soft palate (1,3,9,11). The lesion shows striking predilection for adolescent males between the age of 10 and 17 years (1-3). Hence it is termed as ju\ enile nasopharyngeal angiofibroma (1). However, rarely it is reported in slightly younger and older patients. It accounts for 0.5 of all neoplasms of the head and neck (4,5). Epistaxis, nasal obstruction, nasal drainage, and nasopharyngeal mass are the presenting signs and symptoms (1-16). Computed tomography and MRI are the primary diagnostic tests (116). Angiography is used for vascular mapping and preoperative embolization. Total surgical resection is the goal of treatment (1-16). CASE REPORT A 20 \car old male paiicnt presented to the Department of Oral Medicine and Radiology. J.S.S. Dental College and Hospital. Mysore, with pain in the right upper back teeth area since one month. Pain was sudden in onset, continuous, moderate in intensity and was radiating to the right temporal area. Patient visited a general dental practitioner for the same problem 12 days prior to visiting our Department and had undergone extraction of a tooth in the right upper jaw due to mobility. He was given medication but pain did not subside. Patient had altered vision in the right eye since 8-10 days. Patient also experienced bleeding and purulent discharge from the right nasai cavity and inability to open the mouth since 6 days. Medical, personal, and family history were non contributor)' to the presenting complaint. On general physical examination, the patient was moderate!)1 built and nourished with normal gait and all his vital signs were within normal limits. Extraoral examination revealed a mild diffuse swelling, situated in the right middle and lower third of the face. The swelling extended anleroposteriorly from 2 cm posterior to the angle of the mouth to tragus of the car and supero-inferiorly from the zygomatic arch to beyond the inferior border of the mandible on the right ride. Skin over the swelling had similar color as that of adjacent normal skin. No secondary signs were associated with the swelhng(Fig. 1). Palpaliion of the swelling revealed no local rise in the temperature. It was tender and soft in consistency. Intra nasal examination revealed deviated nasal septum to the left side.
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