Bilateral juvenile nasopharyngeal angiofibroma: Report of a case

Authors

  • Edward C. Wu MD, MBA,

    1. Department of Head and Neck Surgery, University of California, Los Angeles (UCLA) Medical Center, Los Angeles, CA
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  • Davin W. Chark MD,

    1. Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine Medical Center, Orange, CA
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  • Naveen D. Bhandarkar MD

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine Medical Center, Orange, CA
    • Correspondence to: Naveen D. Bhandarkar, MD, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, 101 The City Drive South, Bldg. 56, Suite 500, Orange, CA 92868; e-mail: nbhandar@uci.edu

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  • Potential conflict of interest: None provided.

  • Presented as a poster at the 2012 Combined Otolaryngological Spring Meetings, American Rhinologic Society section, April 19, 2012, San Diego, CA.

Abstract

Background

Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign neoplasm of the nasopharynx. Almost always unilateral on diagnosis, JNAs are locally invasive and may extend across the midline, giving a false bilateral appearance; as such, true bilateral JNA is exceedingly rare. We present a recent case of true bilateral JNA.

Methods

Single case report of a patient with bilateral JNA, including clinical presentation, diagnosis, and management.

Results

The patient presented with unilateral nasal obstruction and recurrent epistaxis. Computed tomography and magnetic resonance imaging demonstrated bilateral, noncontiguous masses. Angiography revealed independent vascular supplies from each respective side with no bilateral supply noted. The patient underwent preoperative embolization followed by endoscopic surgical removal of the larger mass; no complications were noted. Follow-up at 2 years demonstrated no recurrence or growth.

Conclusion

The vast majority of JNAs are unilateral, though invasive growth to the contralateral side may appear “bilateral” in presentation. Proper identification of true bilateral JNA is helpful in guiding management, wherein excision of both tumors may not be necessary.

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