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Nasal septum angiofibroma: a rare condition with an unusual onset

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2019, v.45 no.1, pp.43-47
https://doi.org/10.5125/jkaoms.2019.45.1.43
Maria Carla Spinosi (S.M. alle Scotte University Hospital of Siena)
Francesca D’Amico (S.M. alle Scotte University Hospital of Siena)
Chiara Mezzedimi (S.M. alle Scotte University Hospital of Siena)
Cristiana Bellan (University of Siena, Siena, Italy)
Manuela Cirami (University of Siena)
Ilaria Innocenti Paganelli (S.M. alle Scotte University Hospital of Siena)

Abstract

The characteristics of extra-nasopharyngeal angiofibromas tend to be different from angiofibromas of the nasopharynx according to patient gender, patient age, prevalence, affected site, pathogenesis, and clinical and epidemiological features. We report a case of an extra-nasopharyngeal angiofibroma in a 28-year-old man referred to the ENT Clinic for right-sided epistaxis, airflow impairment and nasal swelling. The right nostril was completely occluded works by a reddish-yellow mass that bled easily. The computed tomography scan revealed an “inhomogeneous solid lesion in the nasal fossa”. With the patient under general anesthesia, the formation in the anterior portion of the right side of the nasal septum was removed up to its vascular base. Although electrical cauterization efficiently controlled the bleeding, we abraded the sub-perichondral area to prevent further bleeding as well as recurrence. The histological exam report confirmed the diagnosis of angiofibroma. As in our case, epistaxis is commonly the presenting sign of angiofibroma. Yet its onset was peculiar, given that the bleeding started with a low impact trauma. The nasal swelling was also a relevant feature as well as the breathing impairment. Although uncommon, nasal septal angiofibromas should considered in patients with epistaxis.

keywords
Angiofibroma, Nasal septum, Epistaxis

Journal of the Korean Association of Oral and Maxillofacial Surgeons