Uncommon presentation of a benign nasopharyngeal mass in an adolescent: comprehensive review of pediatric nasopharyngeal masses

Abstract

Nasopharyngeal masses in the pediatric population are quite rare, and the majority of these are benign. In adolescent boys, there should be a high index of suspicion for juvenile nasopharyngeal angiofibromas. When malignant, the most common lesions encountered are rhabdomyosarcomas, carcinomas, and lymphomas. We report a single case from a tertiary care institution of an adolescent male with an unusual presentation of a benign nasopharyngeal mass and provide a comprehensive review of pediatric nasopharyngeal masses. Whenever possible, radiographic imaging should be obtained, in addition to biopsy, to assist in the diagnosis of pediatric nasopharyngeal masses.

Figure 1

CT axial image demonstrating extension of soft tissue from the nasopharynx on the left side.

Figure 2

CT coronal image demonstrating a nasopharyngeal mass.

Figure 3

MRI coronal image demonstrating a pedunculated 3.1 × 1.7 × 1.2 cm nonvascular mass emanating from the left nasopharynx.

Figure 4

Low Power Field. Squamous mucosa with infiltrating lymphocytes.

Figure 5

High Power Field. Reactive germinal center. Note the “polarization” of the follicle. The dark zone (at the top in this picture) is made up of immature lymphocytes (ie, centroblasts), and the light zone (at the bottom in this picture) is made up of more mature centrocytes which mature and then move out into the mantle and marginal zones further to the bottom.