Angiofibromas are benign tumors that grow in the nasal cavity, mostly in adolescent boys. Symptoms include nasal congestion, nosebleeds, and difficulty breathing. Treatment options include hormone therapy, radiation therapy, and surgery. The cause is unknown, but hormones may play a role.
An angiofibroma is a benign tumor that grows in the nasal cavity. This type of cancer almost always occurs in adolescent boys and may be called juvenile nasopharyngeal angiofibroma. These tumors are not cancerous and only rarely become cancerous. Even so, these benign tumors can grow very quickly and sometimes spread from the nasal cavity to other parts of the skull.
The most common symptoms of angiofibroma are nasal congestion, headache, nosebleed, facial swelling, difficulty breathing through the nose, and nasal speech. Children with angiofibromas might also develop a condition called otorrhea, in which fluid drains from one or both ears. The diagnosis of these nasopharyngeal tumors is usually made based on medical imaging tests such as MRI scans, CT scans, and X-rays. Your child might also undergo an arteriogram, a procedure that allows the doctor to visualize the blood supply that feeds the cancer.
The underlying cause of angiofibromas is unknown. Because these tumors develop almost exclusively in boys between the ages of 7 and 19, it is thought that hormones may play a role in triggering their growth. Genetic studies indicate the involvement of at least one gene known to play a role in the development of several types of malignancies.
There are three main types of treatment for juvenile nasopharyngeal angiofibroma: hormone therapy, radiation therapy, and surgery. Hormone therapy involves the use of a drug called flutamide, which works by blocking testosterone receptors. The activity of this drug is further evidence of a hormonal cause for the condition. Treatment with flutamide can shrink tumors by more than 40%.
Another treatment option for these tumors is radiation therapy. Although radiation therapy has been reported to have cure rates of up to 90%, this treatment is not commonly used, due to its possible long-term side effects on fertility. Radiation therapy is usually used only for recurring tumors or when the tumor has spread from the nasal cavity to other parts of the skull.
Surgery may be needed when the tumor becomes large enough to block the airways or causes repeated nosebleeds. When surgery is needed, the size and location of the angiofibroma will determine the type of surgical procedure used to remove it. Access to the nasal passages where the tumor is located is often achieved through the use of a Weber-Ferguson incision, which is a long incision made parallel to one side of the nose.
Another surgical approach is intranasal access, in which an endoscope is used to provide access to the tumor through the nasal passages without making any facial incisions. This endoscopic technique is increasingly popular because it is much less invasive than other surgical techniques and has fewer risks and complications. For example, a Weber-Ferguson incision can cause temporary or permanent numbness in the cheek, a complication that is completely avoided by the use of intranasal endoscopy.
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