Introduction: Angiomyolipoma (AML), a benign mesenchymal tumor that commonly arises from the kidney, may be associated with tuberous sclerosis complex and perivascular epithelioid cell tumors (PEComas). Nasal angiomyolipoma is very rare and usually occurs in elderly individuals with epistaxis and nasal obstruction. Case Report: We report a rare case of nasal angiomyolipoma in a young male. To the best of our knowledge, this is the first documented case of angiomyolipoma originating from the posterior end of the inferior turbinate, clinically mimicking JUVENILE NASOPHARYNGEAL ANGIOFIBROMA (JNA). The tumor was removed completely via coblator-assisted endoscopic sinus surgery. The patient was asymptomatic at a 2-year follow-up. Conclusion: Nasal AML located in the posterior nasal cavity in a male patient can mimic the presentation of JNA. A computed tomography scan of the paranasal sinuses played an important role in differentiating nasal AML from JNA. The coblator-assisted endoscopic technique is useful in controlling intraoperative hemostasis in the removal of a suspicious vascular tumor.

A 14-year-old male suffering from a giant JUVENILE NASOPHARYNGEAL ANGIOFIBROMA became a candidate for elective operation. The operation was successful but was associated with massive hemorrhage, cardiac dysrhythmia and ventilatory failure, probably due to massive transfusion. The patient was discharged from hospital in acceptable general condition after three weeks.

JUVENILE NASOPHARYNGEAL ANGIOFIBROMA (JNA) generally occurs in male adolescents. Surgery is the first line of treatment, which is performed preferably endoscopically, nowadays. Our knowledge is limited regarding the origin and natural history of the tumor, but it seems that ANGIOFIBROMA should be considered a vascular malformation or hamartoma rather than a neoplasm. As it matures gradually, the vascular tissue regresses and the fibrotic part grows. This may be the reason why the tumor becomes stable or even why residual mass after surgical procedure regresses. We reviewed a few cases with full pre- and postoperative imaging, in which postoperative residue showed no growth in the long time. The symptoms of the patients, the common sites of recurrences and the surgical indications for JNA revision surgery are all discussed, respectively. In our experience, the most important indications for the revision surgery of JNA are the presence of symptoms such as visual disturbances or nasal obstruction, and tumor growth when you follow the patient with imaging. The main concept of this type of regression with complementary information in this regard can change management strategies for JUVENILE NASOPHARYNGEAL ANGIOFIBROMA.

NASOPHARYNGEAL masses in young males, first of all presumes JUVENILE NASOPHARYNGEAL ANGIOFIBROMA (JNA) in the mind, but other benign or malignant tumors should be considered for successful and adequate management of patients and also for minimizing morbidity from unnecessary interventions. We herein present a patient with NASOPHARYNGEAL carcinoma (NPC) mimicking JNA. The patient was presumed as JNA and underwent excessive surgical intervention and the final histopathology report was NPC. The aim of our case report is to highlight the importance of complete clinical examination and preoperative imaging in differentiating and ideal management of NASOPHARYNGEAL masses.

Background: We aimed to investigate the length of hospital stay for resection of JUVENILE NASOPHARYNGEAL ANGIOFIBROMA (JNA) as it relates to preoperative embolization status. Methods: Pediatric males (0-18 years old) with the diagnosis of a benign neoplasm of the nasopharynx who underwent surgical resection between 2004 and 2022 were included in this retrospective cohort study. Patients were then separated into two groups based on their preoperative embolization status. Length of stay between the two groups and intercenter variation in length stay was investigated. Results: 706 patients, with a mean age of 14 years, were analyzed. 114 patients received embolization prior to surgical resection while 592 patients did not receive preoperative embolization. The age of admission, gestational age, and ethnicity were consistent between the two groups. The length of stay for the group that received preoperative embolization was 3 days, while the length of stay for the no embolization group was 2 days. In addition, nine centers were identified as having significantly higher inter-center variation in LOS. Conclusions: Embolization prior to removal of JNA increases the length of stay, despite having similar rates of transfusion. While the difference in length of stay can likely be explained by the fact that patients get admitted a day prior to surgery for embolization, it is unclear why there is significant inter-center variation.

Twelve cases of JUVENILE NASOPHARYNGEAL ANGIOFIBROMA diagnosed by endoscopic examination, computed tomography, and angiography, were selected for endoscopic resection. Tumor staging ranged from stage IA to IIB. Ten patients underwent preoperative selective arterial embolization and in one case selective arterial ligation was employed. In general, the tumors were approached through nasal and oral cavities with 0° and 30° 4mm telescopes without any incision and no packing at their termination. The patients were followed by endoscopy and computed tomography. There was a dramatic decrease in intraoperative bleeding and postoperative morbidity. No early postoperative complications were seen. Two recurrences were observed in twelve patients up to a mean follow-up of 15 months. Minimal bleeding, decreased morbidity, and shorter hospitalization period were the main reasons that prompted us to employ endoscopic technique for the removal of JUVENILE NASOPHARYNGEAL ANGIOFIBROMA.

JUVENILE NASOPHARYNGEAL ANGIOFIBROMA (JNA) is a rare, benign and locally invasive tumor. Massive bleeding because of vascularity of tumor and postoperative recurrence are potential problems of management. Endonasal approach reduces the rate of postoperative recurrence, intraoperative bleeding, and complications of surgery, time of operation and duration of hospitalization. In this article, we review the indications and contraindications of endoscopic surgery, indications of radiotherapy in treatment of JNA and our policy in postoperative follow-up and management of patients.

Introduction: JUVENILE NASOPHARYNGEAL ANGIOFIBROMA (JNA) is uncommon benign tumor that occur exclusively in the lateral portion of nasopharynx of adolescent boys. Sex selectivity at JNA may suggest relation its pathogenesis to hormonal changes of pubertal period. Some reports showed indirect evidence for the presence of androgen (AR), estrogen (ER), and progesterone (PR) receptors, in these tumors.The goal of the current study was to show direct evidence of sex hormone receptor expression in ANGIOFIBROMA with use of immunohistochemical technique and to document which cells population express these receptors.Materials and Methods: 30 cases of JUVENILE NASOPHARYNGEAL ANGIOFIBROMA and equal number of normal NASOPHARYNGEAL tissue were selected from archive of pathology department of mashhad Ghaem hospital then standard Immunohistochemical technique was performed in theirs paraffin blocks with ER, PR and AR immunohistochemical markers. Nuclear immunoreactivity was examined in stromal and endothelial cells of each case then these results analyzed with Pearson Chi-Square test.Results: AR, and ER expression was seen in ANGIOFIBROMA in 80% and 26.7% and in normal tissue 26.7% and 10% of cases respectively. We did not find any PR expression in both normal and tumoral tissue. Differences between AR expression in tumoral and normal tissue was meaningful but this correlation do not true about ER and PR.Conclusions: our results maybe agree with the significant role of androgen receptors in the pathogenesis of ANGIOFIBROMA and benefit of antiandrongeic drugs for therapeutic response.

Background: This retrospective study was conducted to determine the prevalence of NASOPHARYNGEAL ANGIOFIBROMA according to age, stage, clinical signs and average blood transfusion during surgery in educational hospitals affiliated to Isfahan University of Medical Sciences.Methods: This retrospective study was conducted on 250 records of patients suffering from ANGIOFIBROMA and hospitalized from 1988 to 2003 in Al-zahra and Ayatollah Kashani hospitals, affiliated to Isfahan University of Medical Sciences.Findings: All cases were male, and the mean age was 16 years with a range of 7 to 41; the highest prevalence was found in the 11-20-year-age group.The most frequent sign was epistaxis (80%) and nasal obstruction (70%). The average volume of blood transfusion during the surgery was 4-5 units. The most frequent stage at the time of diagnosis was lIB and IIC (complete invasion of petrygomandibular fossa and protrusion to infratemporal fossa) and the rarest stage was IA and IIA according to Session classification.Conclusion: ANGIOFIBROMA is a rare tumor; however it is the most frequent NASOPHARYNGEAL tumor in young adults. Although it has benign histology, but can have important side effects. Its early diagnosis and treatment can prevent its side effects and may facilitate the surgery; hence it should be considered in the differential diagnosis of NASOPHARYNGEAL disorders.

JUVENILE ANGIOFIBROMA is a benign, highly vascular, fibromatous or ANGIOFIBROMAtous hamartoma that is locally invasive, arises from the nasopharynx, and has a marked tendency to recur. JNAs constitute 0.5% of head and neck tumors and are found almost exclusively in adolescent males.152 male cases of JUVENILE ANGIOFIBROMA (JNA) be-tween 13-24 y/o with a mean age of 15 years were embolized during 2001-2009 in Al Assad University Hospital, Damascus, Syria.All cases were referred by the ENT department. The procedure was performed in most cases by Vert diagnostic catheter (5F, 120). Until 2003, we used polyvinyl alcohol (PVA) and coils for embolization and then only PVA was used, except in five cases tin which we used Tris- acrylgelatin microspheres. The PVA particles tend to group within the vessel and occlude the proximal lumen and cause intraluminal thrombosis with an inflammatory reaction and thrombus organises later.No major complications were reported and just a few cases had headache and tooth pain.Twelve cases were referred again due to relapsing tumor: four cases due to late surgery (re-embolization was performed) and eight cases due to co-existing feeding vessels from ECA and ICA through its meningeal territories (no embolization was carried out). By experience, it was found that major difficulties in embolization of JNA are in cases that have feeding vessels from meningeal territories of ICA which are very narrow and it is not easily possible to embolize them.