Gambaran ekspresi reseptor estrogen β pada angiofibroma nasofaring belia dengan menggunakan pemeriksaan imunohistokimia

Background: Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign hormonal related fibrovascular tumor which originates from superoposterior area of sphenopalatine foramen. Purpose: To determineER-ß expression of JNA patient at Cipto Mangunkusumo Hospital. Method: Descriptive study to determine ß-estrogen receptor (ER-ß) on 27 JNA patients who had been treated at Oncology Division ENT Departement Cipto Mangunkusumo Hospital between 2001-2008 was conducted. Results: ER-ß expression of JNA in this study is 100%. Based on ER-ß staining intensity, 18.5% gave strong intensity, 29.6% with moderate intensity, and 51.9% with weak intensity. According to positive ER-ß cellular, it consist of three groups: less than 25% positive, 25-50% positive, and more than 50% positive, and the result is 3.7%, 3.7%, and 92.6% respectively. Conclusion: Immunohistochemical examination revealed 100% ER-ß expression. Keywords: Juvenile nasopharyngeal angiofibroma (JNA), ER-ß expression Abstrak : Latar belakang: Angiofibroma nasofaring belia (ANB) adalah suatu tumor fibrovaskular jinak, berasal dari area superoposterior foramen sfenopalatina dan diduga berhubungan erat dengan faktor hormonal. Tujuan: Melihat gambaran ekspresi ER-ß pada penderita ANB di RS. Cipto Mangunkusumo. Metode: Penelitian deskriptif untuk melihat gambaran ekspresi reseptor estrogenß (ER-ß) pada 27 kasus angiofibroma nasofaring belia (ANB) yang berobat dari tahun 2001 hingga 2008 di Divisi Onkologi Departemen Telinga Hidung Tenggorok RS. Cipto Mangunkusumo. Hasil:Didapati ekspresi ER-ß pada ANB sebesar 100%. Berdasarkan intensitas pewarnaan terhadap ER-ß didapatkan 18,5% mempunyai intensitas pewarnaan yang kuat, 29,6% intensitas pewarnaannya sedang dan 51,9% memiliki intensitas pewarnaan yang lemah. Tiga koma tujuh persen termasuk kelompok dengan jumlah sel yang positif mengandung ER-ß kurang dari 25%, 3,7% termasuk kelompok dengan jumlah sel 25-50%, dan 92,6% termasuk kelompok dengan jumlah sel yang positif mengandung ER-ß>50%. Kesimpulan: Hasil pemeriksaan imunohistokimia menunjukkan ekspresi ER-ß pada semua kasus (100%). Kata kunci: angiofibroma nasofaring belia (ANB), tumor fibrovaskuler, ekspresi ER-ß

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Assisted resection of lateral extension of juvenile nasopharyngeal angiofibroma using a sphenopalatine fossa dissector

The Journal of Laryngology & Otology ◽

10.1017/s0022215118000798 ◽

2018 ◽

Vol 132 (7) ◽

pp. 657-660

Author(s):

A Mishra

Keyword(s):

Residual Disease ◽

Juvenile Nasopharyngeal Angiofibroma ◽

Incomplete Resection ◽

Lateral Extension ◽

Recurrence Rates ◽

Nasopharyngeal Angiofibroma ◽

Sphenopalatine Foramen ◽

Transpalatal Approach ◽

Inaccessible Area ◽

Device Use

AbstractBackgroundJuvenile nasopharyngeal angiofibroma often attaches firmly to the adjoining bony region around the sphenopalatine foramina–sphenopalatine fossa–pterygomaxillary fissure. This can result in hourglass-shaped constriction and predispose to incomplete resection (residual disease) with a transpalatal approach. This paper describes attempts to address this ‘inaccessible’ area with a novel instrument, used since 2012.MethodsMeasurements of the sphenopalatine foramen, nasal septum, posterior nasopharyngeal wall and hard palate were undertaken in 20 skulls and 10 computed tomography scans (lateral extension). A device was designed (in terms of angulation and length) following several trials with malleable wire. A search of patents was also undertaken. Recurrence rates were compared in cases of device use and non-use.ResultsThe novelty of the sphenopalatine fossa dissector was established and the device was patented. This device has significantly improved our 17.59 per cent recurrence rate of the past 4 decades; of 63 cases over 3 years, there were only 3 recurrences and 2 residual disease cases. Findings of our previous studies with or without the device are compared.ConclusionExisting evidence supports the incorporation of this inexpensive instrument in the armamentarium for resecting lateral extension of juvenile nasopharyngeal angiofibroma during a transpalatal approach.

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Vascular Endothelial Growth Factor Expression in Correlation with Stage Juvenile Nasopharyngeal Angiofibroma

Althea Medical Journal ◽

10.15850/amj.v8n2.2170 ◽

2021 ◽

Vol 8 (2) ◽

Author(s):

Ifiq Budiyan Nazar ◽

Yussy Afriani Dewi ◽

Agung Dinasti Permana

Keyword(s):

Vascular Endothelial Growth Factor ◽

Growth Factor ◽

Clinical Stage ◽

Staining Intensity ◽

Juvenile Nasopharyngeal Angiofibroma ◽

Vascular Endothelial ◽

Vegf Expression ◽

Cross Sectional ◽

Nasopharyngeal Angiofibroma ◽

Endothelial Growth Factor

Background: Juvenile Nasopharyngeal Angiofibroma (JNA) is a benign tumor of mesenchymal tissue, originating from the stromal and blood vessels with dense collagen. However, JNA has a malignant tumor-like property because it can cause erosion of surrounding bone. Vascular Endothelial Growth Factor (VEGF) plays a role in the angiogenesis process. The expression of VEGF is the best marker to determine the occurrence of angiogenesis in JNA. This study aimed to determine the correlation between VEGF expression and JNA clinical stage. Methods: This was a cross-sectional correlational analytic observational study on medical records and paraffin blocks of all patients with JNA at Dr. Hasan Sadikin General Hospital Bandung during the period of 2016 to 2019. Immunohistochemistry examination of VEGF expressions was performed and VEGF expression was rated based on staining intensity, percentage distribution, and histoscore. Data were then analyzed using the Spearman correlation test.Results: Of 24 patients, 23 males and 1 female, 58% demonstrated a strong intensity of staining. The positivity of VEGF cell percentage was identified as 26–50% (n=6 patients), 51–75% (n=11), and >75% (n=7). The median VEGF histoscores were 2.5, 6.5, and 12 in JNA stage I, stage II, and stage 3, respectively, with the greater VEGF histoscore had a higher clinical stage with a correlation coefficient of (rs) 0.723 (p=0.002). Conclusions: There is a strong correlation between increased VEGF expression and JNA clinical stage. VEGF expression can be used as a prognostic factor of JNA.

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JUVENILE NASOPHARYNGEALANGIOFIBROMA: OUR EXPERIENCE AND LITERATURE REVIEW

Pakistan Postgraduate Medical Journal ◽

10.51642/ppmj.v32i01.406 ◽

2021 ◽

Vol 32 (01) ◽

pp. 03-08

Author(s):

Adeel Niaz ◽

Muhammad Iqbal ◽

Muhammad Ilyas ◽

Ghulam Dastgir Khan ◽

Riaz Ahmed Shahid ◽

...

Keyword(s):

Endoscopic Surgery ◽

Early Stage ◽

Infratemporal Fossa ◽

Operating Time ◽

Juvenile Nasopharyngeal Angiofibroma ◽

Nasopharyngeal Angiofibroma ◽

Sphenopalatine Foramen ◽

Institutional Review ◽

Early Tumor ◽

Hospital Study

ABSTRACT Introduction: Juvenile nasopharyngeal angiofibroma is a benign vasculartumor.It is commonly found in teen age males. Its site of origin is sphenopalatine foramen. Exact pathogenesis of angiofibroma is not known. It has predictable natural history and growth pattern. This tumor most often involves nasopharynx, nasal cavity, paranasal sinuses, pterygopalatine fossa and infratemporal fossa. It can also involve orbit and can spread intracranially. Its very important to diagnose this tumor very early on the basis of clinical examination and imaging. As early tumor confined to nose and sinuses can be removed exclusively with endoscope. It is very helpful to do angiography before surgery to ascertain itsblood supply and then embolization can be done to reduce intraoperative bleeding. Objective: To describe our experience of Juvenile Nasopharyngeal Angiofibroma cases in ENT Unit-I of Lahore General Hospital. Study Design: Descriptive Study with retrospective analysis after approval from Institutional Review Board (IRB) of LGH/PGMI/AMC Lahore. Methods: We studied 20 patients who underwent surgery in our department from October 2019 to October 2020. We analyzed following factors: age, gender, symptoms, staging, mode of surgery and need for intraoperative blood transfusion, hospital stay, complications and recurrences. Results: Range of patient’s age was 12 to 25 years. Eight patients underwent surgery with endoscope. Mean blood loss was about 400 ml and mean operating time was 140 minutes. All the cases were embolized preoperatively. Conclusion: Endoscopic surgery is a safe and effective method in early stage JNA patients. While patients with advance stage tumors should be managed with combined endoscopic and conventional open approaches. KEYWORDS: juvenile nasopharyngeal angiofibroma, JNA, endoscopic surgery

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Juvenile nasopharyngeal angiofibroma – literature review and case series

Romanian Journal of Rhinology ◽

10.2478/rjr-2018-0002 ◽

2018 ◽

Vol 8 (29) ◽

pp. 17-24

Author(s):

Alexis Vuzitas ◽

Claudiu Manea

Keyword(s):

Literature Review ◽

Infratemporal Fossa ◽

Case Series ◽

Growth Patterns ◽

Juvenile Nasopharyngeal Angiofibroma ◽

Intracranial Extension ◽

Nasopharyngeal Angiofibroma ◽

Sphenopalatine Foramen ◽

Vascular Origin ◽

Rare Benign Tumour

Abstract Juvenile nasopharyngeal angiofibroma is a rare benign tumour of vascular origin found in adolescent males, originating around the sphenopalatine foramen. Although the exact pathogenesis of the tumour is not yet known, natural history and growth patterns can be predicted. JNA progressively involves the nasopharynx, nasal cavity, paranasal sinuses, pterygopalatine fossa, infratemporal fossa and, in severe cases, an orbital or intracranial extension can be seen. Early diagnosis based on clinical examination and imaging is mandatory to ensure the best resectability of the tumour, as small to moderate tumours can be managed exclusively endoscopically. Preoperative angiography can reveal the vascular sources and allow embolization to prevent significant bleeding. We present a brief literature review followed by our case series of endoscopic removal of 7 juvenile nasopharyngeal angiofibromas.

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