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Case Reports
. 2022 Feb 7;15(2):e246490.
doi: 10.1136/bcr-2021-246490.

Middle turbinate angiofibroma in an adolescent boy

Mohamed Faizal Hassan  1 , Kezevino Nagi  2 , Sunil Kumar Saxena  1 , Bheemanathi Hanuman Srinivas  3
Affiliations
Case Reports

Middle turbinate angiofibroma in an adolescent boy

Mohamed Faizal Hassan et al. BMJ Case Rep. .

Abstract

Bleeding nasal mass in adolescent boys has customarily been attributed to Juvenile nasopharyngeal angiofibroma. However, little is known regarding the extranasopharyngeal origin of angiofibroma, as highlighted in this case report of a 15-year-old boy who presented with recurrent epistaxis and nasal obstruction. On constructing a working diagnosis of nasal haemangioma, the patient was taken up for endoscopic excision under general anaesthesia. Intraoperative endoscopic findings and histopathological examination revealed the diagnosis of middle turbinate angiofibroma, which is an extremely rare extranasopharyngeal angiofibroma. Consequently, this represents the third described case of a juvenile angiofibroma arising from the middle turbinate.

Keywords: hemangioma; otolaryngology / ENT; pathology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Contrast-enhanced CT of paranasal sinuses showing a heterogeneously enhancing mass occupying the posterior part of the left nasal cavity and the nasopharynx pedicled to the posterior end of the inferior turbinate (Star).
Figure 2
Figure 2
Intraoperative endoscopic image revealing the origin of the tumour (x) from the middle turbinate (MT). Note its relation to the septum (S) and inferior turbinate (IT).
Figure 3
Figure 3
Excised tumour specimen; lobular red-greyish around 30 mm in length and 20 mm in diameter.
Figure 4
Figure 4
Photomicrographs of (A) Specimen shows varying sized blood vessels in a fibrous stroma along with overlying respiratory mucosa (H&E×40): (B) vessels are thin- walled, slit-like ‘staghorn’ or dilated with calibres ranging from capillary size to largepatulous vessels with absent muscular layer (H&E×100): (C) stromal cells show Bland oval nuclei (H&E×200): immunohistochemistry with (IHC) (D) ß-catenin show positivity in stromal cells (DAB×200): (E) IHC with androgen receptor showing scattered cells show positivity (DAB×200): (F) IHC with STAT-6 show negative stromal cells (DAB ×200).
See this image and copyright information in PMC

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