Nasopharyngeal Angiofibroma

Nasopharyngeal Angiofibroma

Lester Thompson, MD

Cyril Fisher, MD, DSc, FRCPath

Low magnification shows an intact surface with a wide variety of vessels in a fibrous stroma. Some of the vessels have smooth muscle, and others do not. Patulous and compressed vessels are noted.

Smooth-muscle-walled vessels image lie close to vessels without smooth muscle image. There are also numerous capillaries in the fibrous stroma. The lesion is moderately cellular and lacks atypia.



  • Juvenile angiofibroma (JNA)

  • Angiofibroma (AF)


  • Angiomyofibroblastoma-like tumor

  • Angiofibroma

  • Fibroangioma

  • Fibroma


  • Benign, highly cellular, and richly vascularized mesenchymal neoplasm arising in nasopharynx in males



  • Testosterone-dependent puberty-induced growth can be blocked with estrogen &/or progesterone therapy


  • Reported association with familial adenomatous polyposis



  • Incidence

    • < 1% of all nasopharyngeal tumors

    • < 0.1% of all head and neck neoplasms

  • Age

    • < 20 years old

      • Adolescents to young men

      • Peak in 2nd decade of life

  • Gender

    • Males exclusively

    • If diagnosed in female, studies of sex chromosomes required to confirm gender

  • Ethnicity

    • Worldwide distribution

    • Higher frequency in Caucasians

      • Favors fair-skinned, red-haired individuals


  • Nasopharynx usually affected

  • Pterygoid region usually affected

  • May expand to involve surrounding structures (30% of cases)

    • Anterior: Nasal cavity and maxillary sinus via roof of nasopharynx

    • Lateral: Temporal and infratemporal fossae via pterygomaxillary fissure, resulting in cheek or intraoral buccal mass

    • Posterior: Middle cranial fossa

    • Superior: Pterygopalatine fossa and orbit via inferior and superior orbital fissures resulting in proptosis

    • Medial: Contralateral side


  • Nasal obstruction

  • Recurrent, spontaneous epistaxis

  • Nasal discharge

  • Facial deformity (proptosis), exophthalmia, diplopia

  • Rhinolalia, sinusitis

  • Otitis media, tinnitus, deafness

  • Headaches

  • Rarely, anosmia or pain

  • Symptoms present for 12-24 months (nonspecific presentation)


Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Nasopharyngeal Angiofibroma
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