Endoscopic resection of juvenile nasopharyngeal angiofibroma with lateral extension without embolization

Juvenile nasopharyngeal angiofibroma (JNA) is a benign yet highly vascular and locally aggressive tumor. Surgical excision remains the mainstay of treatment, though it carries multiple risks, particularly related to intraoperative bleeding and tumor extension into deep anatomical spaces. This case r...

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Main Authors: Halwani Chiraz, PhD, Ferchichi Sana, MD, Awini Ayda, MD, Stambouli Nejla, MD, Askri Haithem, MD, Yazid Yazibene, (Professor)
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325005746
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author Halwani Chiraz, PhD
Ferchichi Sana, MD
Awini Ayda, MD
Stambouli Nejla, MD
Askri Haithem, MD
Yazid Yazibene, (Professor)
author_facet Halwani Chiraz, PhD
Ferchichi Sana, MD
Awini Ayda, MD
Stambouli Nejla, MD
Askri Haithem, MD
Yazid Yazibene, (Professor)
author_sort Halwani Chiraz, PhD
collection DOAJ
description Juvenile nasopharyngeal angiofibroma (JNA) is a benign yet highly vascular and locally aggressive tumor. Surgical excision remains the mainstay of treatment, though it carries multiple risks, particularly related to intraoperative bleeding and tumor extension into deep anatomical spaces. This case report describes a 17-year-old male presented with a congestive, budding nasopharyngeal mass. Imaging findings were suggestive of JNA, with lateral extension into the infratemporal fossa and sphenoid sinus. MRI revealed a vascular blush of early moderate intensity, with intense enhancement and persistence of signal-free punctuation. Endoscopic endonasal surgery was performed without preoperative embolization. Tumor resection was facilitated by bipolar forceps coagulation as exposure progressed. Postoperative endoscopy confirmed complete excision. Histopathological examination confirmed the diagnosis of JNA. The patient was discharged on the first postoperative day. Follow-up at 1 month, 3 months, and 1 year showed no recurrence, with good local healing. This case highlights the advancements in endoscopic endonasal surgery, enabling the complete resection of highly vascularized tumors in deep anatomical locations without the need for preoperative embolization. The findings reinforce the importance of technical developments in improving surgical outcomes.
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spelling doaj-art-0abbc7dd3a4b446783bf1a5f3252bf372025-08-20T03:50:22ZengElsevierRadiology Case Reports1930-04332025-09-012094877488010.1016/j.radcr.2025.06.029Endoscopic resection of juvenile nasopharyngeal angiofibroma with lateral extension without embolizationHalwani Chiraz, PhD0Ferchichi Sana, MD1Awini Ayda, MD2Stambouli Nejla, MD3Askri Haithem, MD4Yazid Yazibene, (Professor)5Corresponding author.; Department of Otorhinolaryngology, Military Hospital of Tunis, Tunis, TunisiaDepartment of Otorhinolaryngology, Military Hospital of Tunis, Tunis, TunisiaDepartment of Otorhinolaryngology, Military Hospital of Tunis, Tunis, TunisiaDepartment of Otorhinolaryngology, Military Hospital of Tunis, Tunis, TunisiaDepartment of Otorhinolaryngology, Military Hospital of Tunis, Tunis, TunisiaDepartment of Otorhinolaryngology, Military Hospital of Tunis, Tunis, TunisiaJuvenile nasopharyngeal angiofibroma (JNA) is a benign yet highly vascular and locally aggressive tumor. Surgical excision remains the mainstay of treatment, though it carries multiple risks, particularly related to intraoperative bleeding and tumor extension into deep anatomical spaces. This case report describes a 17-year-old male presented with a congestive, budding nasopharyngeal mass. Imaging findings were suggestive of JNA, with lateral extension into the infratemporal fossa and sphenoid sinus. MRI revealed a vascular blush of early moderate intensity, with intense enhancement and persistence of signal-free punctuation. Endoscopic endonasal surgery was performed without preoperative embolization. Tumor resection was facilitated by bipolar forceps coagulation as exposure progressed. Postoperative endoscopy confirmed complete excision. Histopathological examination confirmed the diagnosis of JNA. The patient was discharged on the first postoperative day. Follow-up at 1 month, 3 months, and 1 year showed no recurrence, with good local healing. This case highlights the advancements in endoscopic endonasal surgery, enabling the complete resection of highly vascularized tumors in deep anatomical locations without the need for preoperative embolization. The findings reinforce the importance of technical developments in improving surgical outcomes.http://www.sciencedirect.com/science/article/pii/S1930043325005746Juvenile nasopharyngeal angiofibromaCase reportEndoscopic surgeryEmbolization
spellingShingle Halwani Chiraz, PhD
Ferchichi Sana, MD
Awini Ayda, MD
Stambouli Nejla, MD
Askri Haithem, MD
Yazid Yazibene, (Professor)
Endoscopic resection of juvenile nasopharyngeal angiofibroma with lateral extension without embolization
Radiology Case Reports
Juvenile nasopharyngeal angiofibroma
Case report
Endoscopic surgery
Embolization
title Endoscopic resection of juvenile nasopharyngeal angiofibroma with lateral extension without embolization
title_full Endoscopic resection of juvenile nasopharyngeal angiofibroma with lateral extension without embolization
title_fullStr Endoscopic resection of juvenile nasopharyngeal angiofibroma with lateral extension without embolization
title_full_unstemmed Endoscopic resection of juvenile nasopharyngeal angiofibroma with lateral extension without embolization
title_short Endoscopic resection of juvenile nasopharyngeal angiofibroma with lateral extension without embolization
title_sort endoscopic resection of juvenile nasopharyngeal angiofibroma with lateral extension without embolization
topic Juvenile nasopharyngeal angiofibroma
Case report
Endoscopic surgery
Embolization
url http://www.sciencedirect.com/science/article/pii/S1930043325005746
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