Presentation
Nasal obstruction and epistaxis. No history trauma.
Patient Data
Large lobulated enhancing mass lesion is seen involving the region of right sphenopalatine foramen, posterior choana and nasopharynx causing airway narrowing. Bony remodeling with erosions of the posterior nasal septum and medial wall of right maxillary sinus. Superiorly, the mass is extending into the right sphenoid sinus. No intracranial extension. Multiple feeders are seen arsing from the branches of external carotid artery.
Case Discussion
Age, clinical presentation and imaging features are in consistent with diagnosis of juvenile nasopharyngeal angiofibroma. These lesions are locally aggressive and highly vascular, hence biopsy is contraindicated due to risk of hemorrhage. DSA with pre-operative embolization and surgical resection are the treatment of choice.
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