Juvenile angiofibroma
Nasal tumor; Angiofibroma - juvenile; Benign nasal tumor; Juvenile nasal angiofibroma; JNAJuvenile angiofibroma is a noncancerous growth that causes bleeding in the nose and sinuses. It is most often seen in boys and young adult men.
Causes
Juvenile angiofibroma is not very common. It is most often found in adolescent boys. The tumor contains many blood vessels and spreads within the area in which it started (locally invasive). This can cause bone damage.
Tumor
A tumor is an abnormal growth of body tissue. Tumors can be cancerous (malignant) or noncancerous (benign).
Read Article Now Book Mark ArticleInvasive
An invasive disease is one that spreads to surrounding tissues. An invasive procedure is one in which the body is "invaded", or entered by a needle,...
Read Article Now Book Mark ArticleSymptoms
Symptoms include:
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Difficulty breathing through the nose
Difficulty breathing
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
Read Article Now Book Mark Article - Easy bruising
- Frequent or repeated nosebleeds
- Headache
- Swelling of the cheek
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Hearing loss
Hearing loss
Hearing loss is being partly or totally unable to hear sound in one or both ears.
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Nasal discharge, usually bloody
Nasal discharge
A stuffy or congested nose occurs when the tissues lining the nose become swollen. The swelling is due to inflamed blood vessels. The problem may a...
Read Article Now Book Mark Article - Prolonged bleeding
Bleeding
Bleeding is the loss of blood. Bleeding may be:Inside the body (internal)Outside the body (external)Bleeding may occur:Inside the body when blood le...
Read Article Now Book Mark Article - Stuffy nose
Exams and Tests
The health care provider may see the angiofibroma when examining the upper throat.
Tests that may be done include:
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Arteriogram to see the blood supply to the growth
Arteriogram
An arteriogram is an imaging test that uses x-rays and a special dye to see inside the arteries. It can be used to view arteries in the heart, brain...
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CT scan of the sinuses
CT scan of the sinuses
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
Read Article Now Book Mark Article - MRI scan of the head
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X-ray
X-ray
X-rays are a type of electromagnetic radiation, just like visible light. An x-ray machine sends individual x-ray waves through the body. The images...
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Biopsy is generally not recommended due to the high risk of bleeding.
Treatment
You will need treatment if the angiofibroma is growing larger, blocking the airways, or causing repeated nosebleeds. In some cases, no treatment is needed.
Surgery may be needed to remove the tumor. The tumor may be hard to remove if it is not enclosed and has spread to other areas. Newer surgery techniques that place a camera up through the nose have made tumor removal surgery less invasive.
A procedure called embolization may be done to prevent the tumor from bleeding. The procedure may correct the nosebleeds by itself, but it is most often followed by surgery to remove the tumor.
Outlook (Prognosis)
Although not cancerous, angiofibromas may continue to grow and damage nearby tissue or bleed. Some may disappear on their own.
It is common for the tumor to return after surgery.
Possible Complications
Complications may include:
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Anemia
Anemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...
Read Article Now Book Mark Article - Pressure on the brain (rare)
- Spread of the tumor to the nose, sinuses, and other structures
When to Contact a Medical Professional
Contact your provider if you often have:
- Nosebleeds
- One-sided nasal blockage
Prevention
There is no known way to prevent this condition.
References
Chu WCW, Epelman M, Lee EY. Neoplasia. In: Coley BD, ed. Caffey's Pediatric Diagnostic Imaging. 13th ed. Philadelphia, PA: Elsevier; 2019:chap 55.
Fletcher CDM. Tumors of soft tissue. In: Fletcher CDM, ed. Diagnostic Histopathology of Tumors. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 24.
Haddad J, Dodhia SN. Acquired disorders of the nose. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 405.
Nicolai P, Mattavelli D, Castelnuovo P. Benign tumors of the sinonasal tract. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 50.
Snyderman CH, Pant H, Gardner PA. Juvenile angiofibroma. In: Meyers EN, Snyderman CH, eds. Operative Otolaryngology: Head and Neck Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 122.
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Tuberous sclerosis, angiofibromas - face - illustration
These red (erythematous) elevated skin lesions (papules) are tumors made-up of fibrous tissue (angiofibroma) and occur with tuberous sclerosis. Tuberous sclerosis affects both the nervous system and the skin (neurocutaneous) and may also produce other skin lesions including shagreen spots, ash-leaf macula, and periungual fibromas (a type of skin tumor).
Tuberous sclerosis, angiofibromas - face
illustration
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Tuberous sclerosis, angiofibromas - face - illustration
These red (erythematous) elevated skin lesions (papules) are tumors made-up of fibrous tissue (angiofibroma) and occur with tuberous sclerosis. Tuberous sclerosis affects both the nervous system and the skin (neurocutaneous) and may also produce other skin lesions including shagreen spots, ash-leaf macula, and periungual fibromas (a type of skin tumor).
Tuberous sclerosis, angiofibromas - face
illustration
Review Date: 9/10/2023
Reviewed By: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.