Juvenile angiofibroma

Definition

Juvenile angiofibroma is a benign growth of the back of the nose or upper throat (nasopharynx). This tumor contains many blood vessels.

Causes, incidence, and risk factors

Juvenile angiofibroma is relatively uncommon. It typically is discovered in adolescent boys and is associated with nasal congestion, a visible nasal mass, and nosebleeds (epistaxis). The tumor is locally invasive and capable of eroding bone.

Symptoms

• nosebleeds (epistaxis)
  • frequent
  • repeated
• nasal congestion, difficulty breathing through the nose
• nasal discharge, usually blood tinged
• hearing loss
• prolonged bleeding, bruising easily -- episodes are frequent or occur repeatedly (recurrent)

Signs and tests

Angiofibroma may be visible on examination of the nasopharynx.

• An X-ray or a CT scan of the head (nose area) confirms the presence of angiofibroma.
• Nasal mucosal biopsy indicates tumor or polyp.

Treatment

Treatment is required if the angiofibroma is enlarging, obstructing the airway, or causing chronic nosebleeds. In some cases, no treatment is necessary.

Surgical treatment includes removal of the tumor. Removal is often difficult because the tumor is unencapsulated (not enclosed) and may be deeply invasive. Recurrence of the tumor after surgical resection is common.

Clotting of the vessels of the tumor (embolization) may cause the tumor to scar and stop bleeding. Embolization is performed by injecting a substance into the blood vessel to block blood flow through it. Embolization may be adequate by itself to correct the nosebleeds, or it may be followed by surgery to remove the tumor.

Expectations (prognosis)

Although not cancerous, angiofibromas may continue to expand. They may disappear spontaneously. There is a high rate of recurrence after surgical removal.

Complications

• expansion of the angiofibroma to the nose, the sinuses, and other structures
• anemia from chronic blood loss
• pressure on the brain from expansion of the angiofibroma (rare)

Calling your health care provider

Call your health care provider if repeated or frequent nosebleeds occur.

Prevention

There is no known way to prevent this condition.

Illustrations

Nasal mucosa

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