CLINICAL CASES   

Otorinolaringologia 2001 December;51(4):159-63

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: Italian

Nasopharyngeal angiofibroma. Analysis in an elderly subject

Federico B. *, Gallina S. *, Piazza F. *, Restivo S. *, Fazio P. **, Maresi E. ***, Midulla R. ***

Università degli Studi - Palermo *Istituto di Clinica Otorinolaringoiatria Clinica O.R.L. Base **Dipartimento di Chirurgia Oncologica ***Istituto di Anatomia ed Istologia Patologica

This is a rare medical case of nasopharyngeal angiofibroma in an eighty-year-old subject. Histologically, this is a benign tumor and has a predilection for male sex, generally it occurs in adolescence, and is defined “juvenile”. This case in an elderly subject is an exceptional event. This is the only lesion found in an elderly subject out of 320 cases observed during ten years in our institute. This angiofibroma shows a highly thick fibrous tissue, there are vessels in embryostage, with the endothelium only, sometimes widely extended in a superficial disposition. Although it is a benign tumor, it can take a malignant attitude due to the easy bleeding and to the invasion of anatomic adjacent structures, eroded by compression but not infiltrated. There is a tendency to relapse after surgical removal. On the basis of the critical size and hypervascularization of the mass, this therapy was chosen: preoperative arterial embolization by percutaneous arterial catheterization. This technique, using gelfoam which fastly degrade in some weeks, for a temporary occlusion, reduces before surgery the intraoperative bleeding and allows a better demarcation of neoplastic tissue. The surgical excision is often difficult due to profuse bleeding.