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Juvenile Angiofibromas

by Udayan K. Shah, MD

Juvenile angiofibroma is a rare noncancerous (benign) tumor that grows in the back of the nose, in the same area where the adenoids are located (see Figure: Locating the Tonsils and Adenoids).

Juvenile angiofibroma occurs most commonly among adolescent boys. The tumor contains many blood vessels. It can grow slowly, spreading into the area around the brain and into the orbits of the eye.

Typically, the tumor causes a stuffy nose or headache, often with nosebleeds, which are sometimes very severe. The face may swell, or an eye may bulge. A mass may protrude from the nose, or the nose may become disfigured. If the tumor grows slowly, people may have few symptoms.

Doctors suspect the diagnosis based on symptoms. To confirm the diagnosis, doctors do the imaging tests computed tomography (CT—see Computed Tomography) and magnetic resonance imaging (MRI—see Magnetic Resonance Imaging). Another imaging test called angiography (x-rays of blood vessels taken after a dye is injected in the veins to outline them) is often done so that the tumor's blood vessels can be blocked (embolization) before surgery, which reduces bleeding. A partial biopsy of the tumor may be done but is usually avoided because it can result in severe bleeding.

Usually, the tumor is surgically removed. Occasionally, radiation therapy is also used, especially if complete removal of the tumor is difficult or impossible or if the tumor recurs.