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Juvenile Angiofibroma, Nasal

Nguyen DKN - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Madigan Army Medical Center

ABSTRACT

Diagnosis: Juvenile Angiofibroma, Nasal

History: 14-year-old American Samoan male who presents with a history of epistaxis and expansile right facial mass.

Findings: 1. Large hypervascular mass, measuring 9 cm in its greatest longitudinal dimension, which is situated in the region of the right maxillary sinus, with extensive extension to surrounding regions, to include bony destruction of the right pterygoid, tumor extension to the lateral aspect of the right mandible, via the right infratemporal fossa, bony destructive changes of the right base of the skull, to involve the foramen ovale and rotundum, with intracranial extension on the right into the right cavernous sinus. 2. Enlarged right cervical chain lymph nodes at both levels I and II may represent inflammatory enlargement or metastatic disease. There is tumor extension to involve the right cavernous carotid, cranial nerves VII and III, as well as expansion of the vidian canal, with likely involvement of the greater petrousal nerve. 3. Bony destruction of the right maxilla and skull base, are also present. 4. The most likely etiology of this tumor is a juvenile nasal angiofibroma. Other considerations would include a sarcoma or possibly a meningioma.

Ddx: -Juvenile nasal angiofibroma -Sarcoma -Meningioma

Exam: Nasal exam: A mass completely occludes the right naris and is apparent in the right nasal vestibule. Fiberoptic endoscopy of the left naris reveals that the lesion also extends into the posterior left nasal passage. The septum is also mildly deviated to the left. The nasopharyngoscope was unable to be manipulated posterior to this lesion. The mass appears extremely hypervascular in nature. Oral exam reveals no loose dentition. There is firmness noted within the right buccal space. There is also noted some mild fullness in the soft palate with poor palatal elevation. The gag reflex is intact, however. The remaining intraoral mucosa appears normal. Palpation over the right cheek reveals a soft, fluctuant mass extending through the maxillary sinus wall and over the ramus of the mandible. The skin is intact. The lesion is nontender to palpation.

No MeSH data available.


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Juvenile Angiofibroma, Nasal

Nguyen DKN - MedPix

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2230&req=5

View Article: MedPix Image - MedPix Case

Affiliation: Madigan Army Medical Center

ABSTRACT

Diagnosis: Juvenile Angiofibroma, Nasal

History: 14-year-old American Samoan male who presents with a history of epistaxis and expansile right facial mass.

Findings: 1. Large hypervascular mass, measuring 9 cm in its greatest longitudinal dimension, which is situated in the region of the right maxillary sinus, with extensive extension to surrounding regions, to include bony destruction of the right pterygoid, tumor extension to the lateral aspect of the right mandible, via the right infratemporal fossa, bony destructive changes of the right base of the skull, to involve the foramen ovale and rotundum, with intracranial extension on the right into the right cavernous sinus. 2. Enlarged right cervical chain lymph nodes at both levels I and II may represent inflammatory enlargement or metastatic disease. There is tumor extension to involve the right cavernous carotid, cranial nerves VII and III, as well as expansion of the vidian canal, with likely involvement of the greater petrousal nerve. 3. Bony destruction of the right maxilla and skull base, are also present. 4. The most likely etiology of this tumor is a juvenile nasal angiofibroma. Other considerations would include a sarcoma or possibly a meningioma.

Ddx: -Juvenile nasal angiofibroma -Sarcoma -Meningioma

Exam: Nasal exam: A mass completely occludes the right naris and is apparent in the right nasal vestibule. Fiberoptic endoscopy of the left naris reveals that the lesion also extends into the posterior left nasal passage. The septum is also mildly deviated to the left. The nasopharyngoscope was unable to be manipulated posterior to this lesion. The mass appears extremely hypervascular in nature. Oral exam reveals no loose dentition. There is firmness noted within the right buccal space. There is also noted some mild fullness in the soft palate with poor palatal elevation. The gag reflex is intact, however. The remaining intraoral mucosa appears normal. Palpation over the right cheek reveals a soft, fluctuant mass extending through the maxillary sinus wall and over the ramus of the mandible. The skin is intact. The lesion is nontender to palpation.

No MeSH data available.