Juvenile angiofibroma

Definition

Juvenile angiofibroma is a noncancerous growth that causes bleeding in the nose and sinuses. It is most often seen in boys and young adult men.

Alternative Names

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

Causes

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

Symptoms

Symptoms include:

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

Exams and Tests

The health care provider 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 sinuses
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 most often followed by surgery to remove the tumor.

Outlook (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.

Possible Complications

Complications may include:

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

When to Contact a Medical Professional

Contact your provider if you often have:

Nosebleeds
One-sided nasal blockage

Prevention

There is no known way to prevent this condition.

Gallery

Tuberous sclerosis, angiofibromas - face — These red (erythematous) elevated skin lesions (papules) are tumors made-up of fibrous tissue (angiofibroma) and occur with tuberous sclerosis. Tuberous sclerosis affects both the nervous system and the skin (neurocutaneous) and may also produce other skin lesions including shagreen spots, ash-leaf macula, and periungual fibromas (a type of skin tumor).

References

Chu WCW, Epelman M, Lee EY. Neoplasia. In: Coley BD, ed. Caffey's Pediatric Diagnostic Imaging. 13th ed. Philadelphia, PA: Elsevier; 2019:chap 55.

Haddad J, Dodhia SN. Acquired disorders of the nose. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 405.

Nicolai P, Mattavelli D, Castelnuovo P. Benign tumors of the sinonasal tract. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 50.

Snyderman CH, Pant H, Gardner PA. Juvenile angiofibroma. In: Meyers EN, Snyderman CH, eds. Operative Otolaryngology: Head and Neck Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 122.

Last reviewed August 31, 2021 by Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

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