Juvenile Nasal Angiofibroma

These tumors tend to be seen in teenage males and usually originate along the pterygopalatine fossa. They are extremely vascular and can follow blood vessels commonly out to the infratemporal fossa, orbit, and possibly also into the middle cranial fossa. They can represent with nasal obstruction and epistasis. One should check for numerous flow voids and widening of the pterytopalatine foramen.

* Teenage males.

* Epistaxes and/or nasal obstruction.

* Arises from pterygopalatine fossa with frequent destruction of pterygoid plates.

* Extremely vascular: Check for flow voids on MRI. Do not biopsy unless the tumor has been embolized.

* May spread to infratemporal fossa, orbit, skull base.

* Low grade malignancy.

* Usually slow growing, relentless, and recurrent.

* Destroys adjacent architecture by direct invasion.

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