scholarly journals CT scan pitfalls and angiography’s role in juvenile nasopharyngeal angiofibroma: A case report

2021 ◽  
Vol 06 (03) ◽  
pp. 188-193
Author(s):  
Prasetyo Sarwono Putro ◽  
Meutia Apriani ◽  
Muchtar Hanafi ◽  
Vania Puspitasari
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Nasal Cavity ◽  
Nasal Congestion ◽  
Tumor Location ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Maxillary Artery ◽  
Nasopharyngeal Angiofibroma ◽  
Posterior Lesion ◽  
The Right

Diagnosis to treatment of Juvenile Nasopharyngeal Angiofibroma (JNA) required a multidisciplinary approach. CT scan works by combining multi-slice imaging from a device that rotates around the object. The potential of missing certain parts in the scanning process can occur. Angiography was the option to cover the CT scan pitfalls. In this case, we discussed CT scan pitfalls that can be overcome by angiography through JNA case report by showing clearer picture of the JNA and its feeding artery. 14 years old child complained of nasal congestion. On physical examination, the lesion expanded the anterior side of nasal cavity. The patient underwent a synonasal CT scan without contrast. It was obtained a heterogeneous solid mass in the nasopharynx extending to the concha and right and left maxillary sinuses. However, until the preparation of angiography, the actual size of the tumor, as well as the entire vasculature, is not yet known. The angiographic features suggested that the right side (seen in the right maxillary artery) was more dominant than the left side. However, both the right and the left finding reassured that the tumor location was more dominant in the anterior nasal cavity. The posterior lesion was also seen but did not predominate in comparison to the anterior. These findings helped clinicians in planning operative action in order to evacuate the tumor.

Combined Anterior Transmaxillary (Caldwell-Luc) With an Endoscopic Endonasal Transpterygoid Approach for Resection of a Large Juvenile Nasopharyngeal Angiofibroma: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Salomon Cohen-Cohen ◽  
Lucas P Carlstrom ◽  
Jeffrey R Janus ◽  
Jamie J Van Gompel
Keyword(s):  
Nasal Congestion ◽  
Infratemporal Fossa ◽  
Stage Iv ◽  
Video Production ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Preoperative Embolization ◽  
Maxillary Artery ◽  
Endoscopic Endonasal ◽  
Nasopharyngeal Angiofibroma ◽  
The Right

Abstract Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular benign tumor that originates in the sphenopalatine foramen and often spreads to adjacent compartments.1 Microsurgical resection with preoperative embolization remains the treatment of choice.2 We present a case of a large JNA involving multiple compartments. The patient is a 20-yr-old male who presented with long-term right nasal congestion. The MRI demonstrated a large enhancing mass that extended from the right nasal cavity and nasopharynx into the right pterygopalatine fossa (PPF), infratemporal fossa (ITF), and parapharyngeal space. Preoperative angiogram for embolization showed a highly vascular tumor with blood supply mainly from the internal maxillary artery and about 10% from a persistent mandibular branch of the internal carotid artery. Based on the UPMC JNA staging system, this tumor was a stage IV.2 A combined anterior transmaxillary (Caldwell-Luc) with an endoscopic endonasal transpterygoid approach was performed. The addition of the anterior transmaxillary approach increases the surgical freedom for traditional bipolar devices and improves the view and trajectory to more lateral structures like the PPF and ITF.3 Gross total resection was achieved without complications. The patient was discharged home with a partial V2 numbness (right superior gum) that improved with time. The endoscopic endonasal approach is a safe and effective technique even for large JNA. A multidisciplinary team consisting of an interventional radiologist, a skull base neurosurgeon, and an otorhinolaryngologist with expertise in endoscopic surgery may play a role for optimal surgical results. The patient consented for the procedure and for the video production.

scholarly journals Extranasopharyngeal angiofibroma in an adolescent male: a case report

2019 ◽  
Vol 5 (5) ◽  
pp. 1416
Author(s):  
Lourdes Albina Siluvai Arulappan
Keyword(s):  
Case Report ◽  
Nasal Cavity ◽  
Nasal Septum ◽  
Histopathological Examination ◽  
Adolescent Male ◽  
Nasopharyngeal Angiofibroma ◽  
Endoscopic Excision ◽  
Cavity Filling ◽  
Extranasopharyngeal Angiofibroma ◽  
The Right

A 16 year old male presented with complaints of obstruction in the right side of nose for 15 days, 4 episodes of unprovoked bleeding from right nasal cavity for one week. The epistaxis was sudden in onset. CT revealed polypoidal mass in the right nasal cavity, filling inferior 1/3rd of the right anterior nasal cavity, with attachment to the nasal septum. Endoscopic excision of the mass was done in toto and histopathological examination report showed it to be an extra nasopharyngeal angiofibroma.

scholarly journals Bilateral juvenile nasopharyngeal angiofibroma: A rare case report

2021 ◽  
Vol 6 (1) ◽  
pp. 45-52
Author(s):  
Marlinda Adham ◽  
Kartika Hajarani ◽  
Lisnawati Rachmadi ◽  
Indrati Suroyo
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Nasopharyngeal Angiofibroma ◽  
Rare Case Report

scholarly journals Virilization in a Girl with Adrenocortical Adenoma: A Case Report

2013 ◽  
Vol 6 (2) ◽  
pp. 70-72
Author(s):  
Tahniyah Haq ◽  
SM Ashrafuzzaman ◽  
Zafar A Latif
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Adrenal Gland ◽  
Ct Scan ◽  
Dehydroepiandrosterone Sulfate ◽  
Adrenocortical Adenoma ◽  
Adrenal Carcinoma ◽  
Mass Size ◽  
The Right ◽  
Androgen Levels

We present a case of Cushing’s syndrome and virilization in a 15 year old girl which was suspected to be due to an adrenal carcinoma. She presented with features of virilization in addition to those of hypercortisilism. Her high androgen levels especially dehydroepiandrosterone sulfate (DHEAS) were also in favor of an adrenal carcinoma. An unenhanced computerized tomography (CT) scan showed a mass (size: 5.3 cm) in the right adrenal gland with a soft tissue intensity of more than 10 HU which was suggestive of adrenal carcinoma. But, histopathology of the resected mass revealed a benign adrenocortical adenoma. DOI: http://dx.doi.org/10.3329/imcj.v6i2.14736 Ibrahim Med. Coll. J. 2012; 6(2): 70-72

Surviving a Self-inflicted Transorbital Pen Intrusion to the Cerebellum: Case Report

2021 ◽  
Author(s):  
David Breuskin ◽  
Ralf Ketter ◽  
Joachim Oertel
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Foreign Bodies ◽  
Routine Procedure ◽  
Low Velocity ◽  
Foreign Objects ◽  
Surgical Exposure ◽  
The Right ◽  
The Brain ◽  
Do So

Abstract Background Although intracranial traumas by penetrating foreign objects are not absolute rarities, the nature of trauma, the kind of object, and its trajectory make them a one of a kind case every time they occur. Whereas high-velocity traumas mostly result in fatalities, it is the low-velocity traumas that demand an individualized surgical strategy. Methods We present a case report of a 33-year-old patient who was admitted to our department with a self-inflicted transorbital pen injury to the brain. The authors recall the incident and the technique of the pen removal. Results Large surgical exposure of the pen trajectory was considered too traumatic. Therefore, we opted to remove the pen and have an immediate postoperative computed tomography (CT) scan. Due to its fragility, the pen case could only be removed with a screwdriver, inserted into the case. Post-op CT scan showed a small bleeding in the right peduncular region, which was treated conservatively. The patient was transferred back to intensive care unit and woken up the next day. She lost visual function on her right eye, but suffered from no further neurologic deficit. Conclusion Surgical management of removal of intracranial foreign bodies is no routine procedure. Although some would favor a large surgical exposure, we could not think of an approach to do so without maximum surgical efforts. We opted for a minimal surgical procedure with immediate CT scan and achieved an optimal result. We find this case to be worth considering when deciding on a strategy in the future.

scholarly journals Extensive nasopharyngeal angiofibroma – case report

1970 ◽  
Vol 15 (2) ◽  
pp. 75-77
Author(s):  
M Alamgir Chowdhury ◽  
Mousumi Malakar ◽  
SM Golam Rabbani ◽  
Naseem Yasmeen ◽  
Shahidul Islam
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Nasal Cavity ◽  
Neck Region ◽  
Lateral Rhinotomy ◽  
Male Population ◽  
Vascular Neoplasm ◽  
Nasopharyngeal Angiofibroma ◽  
Recurrent Epistaxis ◽  
History Of

Juvenile nasopharyngeal angiofibroma is a benign vascular neoplasm, but it is locally aggressive. This accounts for less than 0.5% of all the neoplasm in the head & neck region in the male population only. Here we report a case of 10-year-old boy with a blackish red smooth polypoidal mass in the nasal cavity, with history of recurrent epistaxis. On physical examination it was suspected as nasopharyngeal angiofibroma. We removed it totally by lateral rhinotomy approach. And the diagnosis was nasopharyngeal angiofibroma on histopathology. Key words: Angiofibroma; Nasopharyngeal. DOI: 10.3329/bjo.v15i2.5061 Bangladesh J Otorhinolaryngol 2009; 15(2): 75-77

scholarly journals Pedunculated Cavernous Hemangioma Originating in the Olfactory Cleft

2014 ◽  
Vol 93 (9) ◽  
pp. E29-E33 ◽  
Author(s):  
Kaiming Su ◽  
Weitian Zhang ◽  
Haibo Shi ◽  
Shankai Yin
Keyword(s):  
Nasal Cavity ◽  
Cavernous Hemangioma ◽  
English Language ◽  
Nasal Congestion ◽  
Rare Condition ◽  
Lateral Wall ◽  
Endoscopic Examination ◽  
Nasopharyngeal Angiofibroma ◽  
Olfactory Cleft ◽  
First Case

Sinonasal cavernous hemangioma is a rare condition that usually affects the lateral wall of the nasal cavity. We report the case of a 77-year-old man who presented with severe epistaxis, nasal congestion, and olfactory dysfunction. Endoscopic examination of the nasal cavity revealed the presence of a red-blue tumor that had almost completely filled the nasopharynx. Preoperatively, it was difficult to distinguish this lesion from a juvenile nasopharyngeal angiofibroma. During endoscopic surgery, the tumor was found to originate in the left olfactory cleft, and it had a long peduncle that contained blood vessels. Postoperative histopathologic examination indicated that the mass was a cavernous hemangioma. To the best of our knowledge, this is the first case of an olfactory cleft cavernous hemangioma and the first case of olfactory cleft disease associated with a cavernous hemangioma to be reported in the English-language literature.

scholarly journals Vallecular cyst in an infant with stridor: a case report

2018 ◽  
Vol 6 (1) ◽  
pp. 58-62
Author(s):  
Nabin Lageju ◽  
Rajendra Prasad Sharma Guragain
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Cystic Lesion ◽  
Failure To Thrive ◽  
Surgical Excision ◽  
Infants And Children ◽  
Solid Component ◽  
Feeding Difficulties ◽  
The Right ◽  
In Infants And Children

Background and Objectives: Vallecular cysts are rare and generally asymptomatic. In infants and children they present with stridor, feeding difficulties, failure to thrive. Treatment is surgical excision with cautery or laser.Presentation of Case: We discuss the clinical, radiological presentation of a 7 months old child with vallecular cyst which was surgically treated with deroofing and marsupialisation with elecrocautery. There was no recurrence even up 2 years of follow-up.Discussion: Flexible nasopharyngolaryngoscopic examination was done which showed present of swelling in the left vallecula pushing the epiglottis posteriorly and to the right with narrowed normal endolarynx. Radiological investigations with CT scan showed cystic lesion noted in left side of neck with no septation and solid component. The lesion was extending to ipsilateral vallecula and paraglottic region with narrowing of endolarynx.Conclusion: Vallecular cyst is rare cause of noisy breathing in infants and children. In adults it is usually asymptomatic. Treatment of choice is marsupialization with electrocautery or laser.

scholarly journals Recurrent Pindborg Tumor of the Maxilla: A Case Report and Review of the Literature

2013 ◽  
Vol 92 (2) ◽  
pp. 84-87 ◽  
Author(s):  
Gangadhara Somayaji ◽  
Aroor Rajeshwary ◽  
Sullia Ramesh ◽  
Sullia Dinesh
Keyword(s):  
Case Report ◽  
Nasal Cavity ◽  
Nasal Obstruction ◽  
Radical Surgery ◽  
Odontogenic Tumor ◽  
Review Of The Literature ◽  
Calcifying Epithelial Odontogenic Tumor ◽  
Pindborg Tumor ◽  
The Right ◽  
Epithelial Odontogenic Tumor

We report a case of recurrent Pindborg tumor (calcifying epithelial odontogenic tumor) of the maxilla. The patient was a 34-year-old woman who had been previously diagnosed with Pindborg tumor and treated with curettage. She was subsequently referred to us for evaluation of nasal obstruction. Examination revealed the presence of a mass lesion in the right nasal cavity and right maxilla, which was identified as a recurrence of her earlier Pindborg tumor. The patient was treated with maxillectomy with orbital preservation. Pindborg tumor is a rare odontogenic tumor; when it does occur, it is more often seen in the mandible than in the maxilla. While this tumor is often treated with curettage alone, the aggressive nature of the recurrence in our patient necessitated radical surgery. We report this case to highlight the need to be suitably aggressive in treating these types of tumors in order to avoid recurrence.

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