Citation Information :
Arora K, Muraleedharan M, Bansal S. Juvenile Nasopharyngeal Angiofibroma with Midline Palatal Ulceration: A Rare Presentation. J Postgrad Med Edu Res 2021; 55 (3):136-138.
Aim: To describe an unusual presentation of juvenile nasopharyngeal angiofibromas (JNAs) in the form of a midline palatal ulceration.
Background: Juvenile nasopharyngeal angiofibromas are benign fibrovascular tumors that usually present with nasal obstruction and epistaxis. They preferably take the paths of least resistance and thereby frank bony erosions are rare.
Case description: A teenaged boy presented with classical features of JNA and midline palatal ulceration with a mass protruding through it, with no previous history of surgical manipulation. After adequate workup, he underwent endoscopic excision of the mass which was postoperatively confirmed to be an angiofibroma.
Conclusion: Rare presentations of a vascular tumor should always be kept in mind while dealing with classical history.
Clinical significance: With nasal obstruction and epistaxis, midline palatal ulcerations should be dealt with caution keeping JNA as a differential; surgical history is of utmost importance.
Rubin R, Strayer DS, Rubin E. Rubin's pathology: Clinico-pathologic foundations of medicine. 5th ed., Lippincott Williams & Wilkins; 2008.
Kabot TE, Goldman ME, Bergman S, et al. Juvenile nasopharyngeal angiofibroma: an unusual presentation in the oral cavity. Oral Surg, Oral Med, Oral Pathol 1985;59(5):453–457. DOI: 10.1016/0030-4220(85)90080-5.
Ray P, Mishra SR. Juvenile nasopharyngeal angiofibroma presenting as a palatal swelling. J Dentis Child 2014;81(2):91–95.
Wheat C, Bickley RJ, Cohen E, et al. Juvenile nasopharyngeal angiofibroma presenting with acute airway obstruction. Case Rep Otolaryngol 2016;2016:1537276. DOI: 10.1155/2016/1537276.
Singh HP, Kumar S, Vashishtha M, et al. Stridor: an unusual presentation of juvenile nasopharyngeal angiofibroma. Case Reports 2014;2014:bcr2013202745.
Schiff M. Juvenile nasopharyngeal angiofibroma: a theory of pathogenesis. Laryngoscope 1959;69(8):981–1016. DOI: 10.1288/00005537-195908000-00001.
Garça MF, Yuca SA, Yuca K. Juvenile nasopharyngeal angiofibroma. Eur J Gen Med 2010;7(4):419–425. DOI: 10.29333/ejgm/82897.
Liu ZF, Wang DH, Sun XC, et al. The site of origin and expansive routes of juvenile nasopharyngeal angiofibroma (JNA). Int J Pediat Otorhinolaryngol 2011;75(9):1088–1092. DOI: 10.1016/j.ijporl.2011.05.020.
Wang WH, Lee SS, Wang LF, et al. Repair oronasal fistula in a treated juvenile nasopharyngeal angiofibroma patient. J Plastic, Reconstruct Aesthe Surg 2007;60(10):1148–1151. DOI: 10.1016/j.bjps.2006.10.007.