​Angiofibroma (Juvenile Nasopharyngeal Angiofibroma)

Diagnosing Angiofibroma

To diagnose angiofibroma, the doctor will perform a physical exam and ask about any symptoms.

Angiofibroma symptoms

The most common symptoms of angiofibroma include:

• Nasal obstruction
• Nose bleeding (epistaxis)
• Runny nose (rhinorrhea)

Some people also may develop facial deformities or abnormalities, including:

• Cheek swelling
• Drooping eyelids
• Bulging eyes
• Cranial nerve palsies

Complications of angiofibroma

• Hearing loss may result from obstruction of the Eustachian tube.
• Double vision or blindness may result from pressure on the optic nerves and chiasm if there is erosion into the cranial cavity.
• Rarely, people with juvenile nasopharyngeal angiofibroma may suffer anosmia — the loss of the sense of smell.

Tests for diagnosing angiofibroma

On physical exam, a pale, smooth mass may be visible inside the nasopharynx.

Because the tumor is composed of blood vessels without a muscular coat, a biopsy could lead to extensive bleeding and doctors generally do not perform one.

An MRI or CT scan of the head and facial bones confirms the clinical diagnosis of angiofibroma and shows the extension of the tumor.

Angiofibroma Treatments

Surgery

The most common treatment for angiofibroma is surgery.

Angiofibromas may be approached directly using the Endoscopic Endonasal Approach (EEA). This state-of-the-art, minimally invasive approach allows surgeons to access the tumor through the natural corridor of the nose, without making an open incision. Surgeons then remove the angiofibroma through the nose and nasal cavities.

EEA offers the benefits of no incisions to heal, no disfigurement, and a faster recovery time.

If you need complementary treatments, such as radiation, those therapies can begin soon after EEA surgery.

Prior to surgery, an angiogram may be performed. This imaging test uses x-rays to view blood vessels that have been injected with a contrasting dye, to allow for embolization of the tumor.

Embolization involves cutting off the blood supply to the tumor. It significantly reduces blood loss during surgery and tumor removal.

Radiation therapy

Radiation therapy may be used for people with angiofibroma tumors that have extended into the cranial cavity, can't be reached safely by surgery, or have returned after previous treatment.

Chemotherapy

Hormonal flutamide, which blocks testosterone receptors, has been shown to reduce tumor size effectively.

The use of this medication is restricted to those enrolled in clinical trials.