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Extranasopharyngeal angiofibroma in children: A case report
Yang-Yan Yan1, Can Lai2, Lei Wu3
1Department of Otorhinolaryngology, Head and Neck Surgery, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, Zhejiang Province, China.
Insights
Extranasopharyngeal angiofibroma, a rare tumor, can affect children of all ages. This study details a pediatric case and reviews 45 others, noting common symptoms like nasal obstruction and bleeding.
Area of Science:
- Pediatric Oncology
- Head and Neck Surgery
- Otolaryngology
Background:
- Extranasopharyngeal angiofibroma (ENF) is a rare benign tumor, with sporadic pediatric cases documented.
- Understanding ENF in children is crucial for timely diagnosis and management.
Observation:
- A case of a 4-year-old boy with ENF is presented, detailing symptoms, imaging, and treatment including embolization and resection.
- The patient experienced a soft-palate perforation due to aseptic necrosis, which healed spontaneously.
- A comprehensive literature review identified 45 pediatric cases of ENF, predominantly affecting adolescents.
Findings:
- The most common sites for pediatric ENF are the maxillary sinus, nasal septum, and inferior turbinate.
- Nasal obstruction and spontaneous rhinorrhagia are the predominant presenting symptoms in children.
- Boys constitute the majority (86.7%) of reported pediatric ENF cases.
Implications:
- ENF can occur across all childhood age groups, not just adolescence.
- Early recognition of symptoms like nasal obstruction and bleeding is vital for pediatric patients.
- This review provides valuable data for understanding the epidemiology and clinical presentation of pediatric ENF.
Background:
Sporadic cases of extranasopharyngeal angiofibroma in children, especially preschool children, have been reported in the literature.
Case Summary:
We present a case of extranasopharyngeal angiofibroma in a 4-year-old boy. The presenting symptoms, imaging findings, treatment, histological appearance, and follow-up data are described in detail. For this patient, we performed embolization on two occasions, and then, resected the tumor completely. During the treatment, the patient developed a soft-palate perforation due to aseptic necrosis. However, the healing ability was good, and the perforation healed spontaneously. We additionally reviewed all pediatric cases of extranasopharyngeal angiofibroma published up to 30 June 2020 in the PubMed, Baidu Scholar, Scopus, and Web of Science databases. We identified 45 pediatric patients [average (10.98 ± 4.86), boys 39 (86.7%)]. The highest proportion of cases occurred in adolescence [22 (48.9%)]. The top three sites of occurrence of extranasopharyngeal angiofibroma in children were the maxillary sinus, nasal septum, and inferior turbinate.
Conclusion:
Extranasopharyngeal angiofibromas can occur throughout childhood, and predominantly present with nasal obstruction and spontaneous rhinorrhagia.
