Juvenile angiofibroma

Answer 1

Definition

Juvenile angiofibroma is a noncancerous growth of the back of the nose or upper throat.

Alternative Names

Nasal tumor; Angiofibroma - juvenile; Benign nasal tumor

Causes, incidence, and risk factors

Juvenile angiofibroma is not very common. It is usually found in adolescent boys. The tumor contains many blood vessels, spreads within the area in which it started (locally invasive), and can cause bone damage.

Symptoms

• Difficulty breathing through the nose
• Easy bruising
• Frequent or repeated nosebleeds
• Hearing loss
• Nasal discharge, usually bloody
• Prolonged bleeding
• Stuffy nose

Signs and tests

The doctor may see the angiofibroma when examining the upper throat.

Tests that may be done include:

• Arteriogram to see the blood supply to the growth
• CT scan of the head
• MRI scan of the head
• X-ray

Biopsy is generally not recommended due to the high risk of bleeding.

Treatment

Treatment is required if the angiofibroma is growing larger, blocking the airways, or causing repeated nosebleeds. In some cases, no treatment is necessary.

Surgery may be needed to remove the tumor. Removal is often difficult because the tumor is not enclosed and may have spread deeply to other areas.

A procedure called embolization may be done to prevent the tumor from bleeding. The procedure may correct the nosebleeds by itself, or it may be followed by surgery to remove the tumor.

Expectations (prognosis)

Although not cancerous, angiofibromas may continue to grow. Some may disappear on their own.

It is common for the tumor to return after surgery.

Complications

• Anemia
• Pressure on the brain (rare)
• Spread of the tumor to the nose, sinuses, and other structures

Calling your health care provider

Call your health care provider if you often have nosebleeds.

Prevention

There is no known way to prevent this condition.

References

Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 4th ed. St Louis, Mo: Mosby; 2005.

Anslow P. Ear, nose and throat radiology. In: Adam A, Dixon AK, eds. Grainger & Allison's Diagnostic Radiology. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 62.

Answer 2

Definition

Juvenile angiofibroma is a noncancerous growth of the back of the nose or upper throat.

Alternative Names

Nasal tumor; Angiofibroma - juvenile; Benign nasal tumor; Juvenile nasal angiofibroma; JNA

Causes, incidence, and risk factors

Juvenile angiofibroma is not very common. It is usually found in adolescent boys. The tumor contains many blood vessels, spreads within the area in which it started (locally invasive), and can cause bone damage.

Symptoms

• Difficulty breathing through the nose
• Easy bruising
• Frequent or repeated nosebleeds
• Hearing loss
• Nasal discharge, usually bloody
• Prolonged bleeding
• Stuffy nose

Signs and tests

The doctor may see the angiofibroma when examining the upper throat.

Tests that may be done include:

• Arteriogram to see the blood supply to the growth
• CT scan of the head
• MRI scan of the head
• X-ray

Biopsy is generally not recommended due to the high risk of bleeding.

Treatment

You will need treatment if the angiofibroma is growing larger, blocking the airways, or causing repeated nosebleeds. In some cases, no treatment is needed.

Surgery may be needed to remove the tumor. The tumor may be hard to remove if it is not enclosed and has spread to other areas. Newer surgery techniques that place a camera up through the nose have made tumor removal surgery less invasive.

A procedure called embolization may be done to prevent the tumor from bleeding. The procedure may correct the nosebleeds by itself, but it is usually followed by surgery to remove the tumor.

Expectations (prognosis)

Although not cancerous, angiofibromas may continue to grow. Some may disappear on their own.

It is common for the tumor to return after surgery.

Complications

• Anemia
• Pressure on the brain (rare)
• Spread of the tumor to the nose, sinuses, and other structures

Calling your health care provider

Call your health care provider if you often have nosebleeds.

Prevention

There is no known way to prevent this condition.

References

Nicolai P, Castelnuovo P. Benign tumors of the sinonasal tract. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 49.

Haddad J Jr. Epistaxis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 369.2.

Reviewed By

Review Date: 08/31/2011

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.