Juvenile Angiofibroma

Coronal CT scan of lesion filling left nasal cavity and ethmoid sinuses blocking maxillary sinuses and deviating septum to the right side.
Media type: CT

Media file 2: Axial CT scan of lesion involving the right nasal cavity and paranasal sinuses. Courtesy of J Otolaryngol 1999;28:145.
Media type: CT

Media file 3: Coronal MRI scan showing extension of the lesion to the cavernous sinus.

Angiofibromas are most common in adolescent boys. The average age being fifteen. There is a theory that it originates from hormonal activity. It is a non cancerous growth of the back of the nose or upper throat. The problem with an angiofibroma is that it continues to grow and can damage facial bones and sinuses. Symptoms of angiofibromas are frequent nosebleeds, stuffy nose or difficulty breathing, chronic nasal discharge and sometimes hearing loss. The best way to detect an angiofibroma is by CT. If the benign tumor is causing bone damage, surgery may be necessary to remove it. If chronic nosebleeds are the problem, embolization can be performed to prevent the tumor from bleeding. In some cases, the tumor can expand into the cranium or ocular orbit. Radiation therapy would be the treatment of choice to temporarily halt the growth of the tumor. Some angiofibromas disappear on their own. However, many continue to grow and can even return after surgery is performed.