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juvenile angiofibroma

Alternative Names 
sinonasal angiofibroma

Definition
A juvenile angiofibroma is a benign, or non-cancerous, tumour made of tissue fibres and blood vessels.

What is going on in the body? 
A juvenile angiofibroma usually develops in the back part of the nasal cavity. It occurs most often in males around the time of puberty. A juvenile angiofibroma does not spread to other areas of the body, and can almost always be cured with treatment.

What are the signs and symptoms of the condition? 
Since this is a tumour made of blood vessels, the main symptom is nose bleeding. Another complaint may be nasal blockage and drainage. If there is significant pressure on the ear canal, then fluid buildup behind the eardrum leading to hearing loss can occur. In rare cases, the tumour may press on the eyes or the brain, causing cause vision changes or headaches.

What are the causes and risks of the condition? 
The cause of this tumour is not known. It occurs almost exclusively in males around the time of puberty.

What can be done to prevent the condition? 
There is no way to prevent this condition.

How is the condition diagnosed? 
Diagnosis begins with the history and physical examination. An abnormal mass can often be seen at the back of the nasal cavity. Imaging tests, such as a cranial CT or cranial MRI, are often done to show the tumour's size and location.

What are the long-term effects of the condition? 
If the tumour is not removed, it can cause severe and even life-threatening bleeding. It may also get larger and destroy tissue around it as it grows.

What are the risks to others? 
A juvenile angiofibroma is not contagious and poses no risk to others.

What are the treatments for the condition? 
Surgical removal of the tumour is the main treatment. A procedure called Cerebral angiography is often done prior to surgery. In this procedure, contrast material is injected into the blood vessels. The contrast material will show the blood vessels that are supplying blood and oxygen to the tumour. These vessels can then be closed during the procedure. This helps to prevent excessive bleeding during surgery, and makes it easier to remove the tumour.

In some cases, radiation therapy or hormone medications may also be used to help treat or shrink the tumour.

What are the side effects of the treatments? 
Any surgery carries a risk of bleeding, infection, and allergic reaction to the anaesthesia. Other rare side effects of this surgery include scarring and loss of feeling in the face. cerebral angiography carries a risk of allergic reaction to the contrast material. Damage to normal arteries can also occur during the procedures, and result in excessive bleeding and other problems.

What happens after treatment for the condition? 
After successful removal of the tumour, the symptoms usually stop and the person is cured. In some cases, the tumour may come back and require further treatment.

How is the condition monitored? 
After treatment, the person will need to see the doctor regularly for a period of time to make sure the tumour hasn't come back. Any new or worsening symptoms should be reported right away to the doctor.

Author: Mark Loury, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 31/1/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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