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Head Neck. 2017 May;39(5):1033-1045. doi: 10.1002/hed.24696. Epub 2017 Feb 15.

Nasal juvenile angiofibroma: Current perspectives with emphasis on management.

Author information

1
Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
2
Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, Spain.
3
Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK.
4
School of Dentistry, University of Liverpool, Liverpool, UK.
5
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
6
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
7
Professorial Unit, Ear Institute, University College London, London, UK.
8
Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
9
Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, Georgia.
10
Departments of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, UK.
11
Department of Pathology, Allegiance Health, Jackson, Michigan.
12
Department of Otolaryngology, Hospital Clinic, University of Barcelona Medical School, Barcelona, Spain.
13
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
14
University of Udine School of Medicine, Udine, Italy.
15
Coordinator of the International Head and Neck Scientific Group.

Abstract

Juvenile angiofibroma is an uncommon, benign, locally aggressive vascular tumor. It is found almost exclusively in young men. Common presenting symptoms include nasal obstruction and epistaxis. More advanced tumors may present with facial swelling and visual or neurological disturbances. The evaluation of patients with juvenile angiofibroma relies on diagnostic imaging. Preoperative biopsy is not recommended. The mainstay of treatment is resection combined with preoperative embolization. Endoscopic surgery is the approach of choice in early stages, whereas, in advanced stages, open or endoscopic approaches are feasible in expert hands. Postoperative radiotherapy (RT) or stereotactic radiosurgery seem valuable in long-term control of juvenile angiofibroma, particularly those that extend to anatomically critical areas unsuitable for complete resection. Chemotherapy and hormone therapy are ineffective. The purpose of the present review was to update current aspects of knowledge related to this rare and challenging disease.

KEYWORDS:

embolization; endoscopy; juvenile nasopharyngeal angiofibroma; sinonasal tumors; surgery

PMID:
28199045
DOI:
10.1002/hed.24696
[Indexed for MEDLINE]

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