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.
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