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Juvenile Angiofibroma - Radiology

last modified on: Tue, 01/23/2024 - 16:24

See also: Juvenile Nasopharyngeal Angiofibroma

See also: Juvenile Nasopharyngeal Angiofibroma (JNA) Anatomy: the Pterygopalatine Fossa

  • A benign vascular tumor of the skull base (Safadi et al. 2018)
  • Rare - representing 0.05 to 0.5% of all head and neck neoplasms (Dimitrijevic et al. 2023)
  • Mostly affects males aged 14 to 25 years old (Dimitrijevic et al. 2023)
  • Site of origin is the sphenopalatine foramen and extension occurs into the nasal cavity, nasopharynx, and pterygopalatine fossa (Safadi et al. 2018)
  • Commonly involves the pterygopalatine fossa and pterygoid base (Safadi et al. 2018)
  • Commonly presents with nasal obstruction and/or epistaxis (Safadi et al. 2018)
  • Oftentimes symptoms are present for 6 months to 1 year before diagnosis (Dimitrijevic et al. 2023)
  • Recurrences occur in 18 to 45% of patients (Dimitrijevic et al. 2023)
  • Primary therapy is surgical treatment (Dimitrijevic et al. 2023)
  • On CT:
    • Non-contrast: soft-tissue density; bony destruction and remodeling; nasal cavity and pterygopalatine fossa are often enlarged
    • Contrast: stongly enhancing lesion
  • On MR:
    • T1-weighting: moderate, heterogenous signal with flow voids an occasional finding
    • T2-weighting: high heterogenous signal also with flow voids
    • T1 post-contrast: fat saturation indicated to allow for visualization of extent of extension, very highly enhancing

References

Safadi A, Schreiber A, Fliss DM, Nicolai P. Juvenile Angiofibroma: Current Management Strategies. J Neurol Surg B Skull Base. 2018 Feb;79(1):21-30. doi: 10.1055/s-0037-1615810. Epub 2018 Jan 18. PMID: 29404237; PMCID: PMC5796815.

Dimitrijevic M, Pavlovic B, Jakovljevic S. Bulky Recurrent Juvenile Nasopharyngeal Angiofibroma. J Craniofac Surg. 2023 Jul-Aug 01;34(5):e468-e470. doi: 10.1097/SCS.0000000000009307. Epub 2023 Apr 14. PMID: 37055882.