Page 51 - Revista Portuguesa - SPORL - Vol 49. Nº3

Angiofibroma do septo nasal:

Uma apresentação extremamente rara

Angiofibroma of the nasal septum:

An extremely unusual presentation

Fernandez Martinez Diaz Argüello Maseda Alvarez Calzada

ABSTRACT INTRODUCTION
Angiofibromas are well-documented tumours occurring almost Angiofibromas are vascular tumours morphologically
exclusively in adolescent boys. They are morphologically benign but locally aggressive. They account for less than CASO CLÍNICO CASE REPORT
benign but can be locally aggressive and destructives. Although 0,5% of all head and neck neoplasms, although they are
most angiofibromas originate in the nasopharynx, they are not the most common benign tumour originating in the
limited to this region. They can involve the nose, paranasal nasopharynx and are exceptional in patients older than
sinuses and cranium, although primary extranasopharyngeal 25 years . Although most of angiofibromas originate in
1
sites are rare. We report a septal angiofibroma, an extremely the nasopharynx they are not limited to this region. They
unusual presentation, in a 54-year old patient. To date only can expand to the nose, paranasal sinuses and cranium.
seven reports have been described in the literature. We However, primary extranasopharyngeal sites are rare.
discuss the differential diagnosis, and treatment. They are most commonly located at maxillary (35%)
Key words: Angiofibroma; nasal septum; extranasopharyngeal. and ethmoidal (12%) sinus . Angiofibromas arising in
1
the nasal cavity are infrequent and the nasal septum
represents an extremely rare localization. To date only
seven reports have been described in the literature .
2-5
Etiology of this tumours remains unknown, nevertheless
appears to arise from the characteristic fibrovascular
stroma normally seen in the nasopharynx. Usually arise
from the posterolateral wall of the nasal cavity, at the
sphenopalatine foramen, being easy to understand
how it can spread to involve the sphenoid sinus and
pterygomaxillary fossa. The natural history of the
tumour is usually a slowly progressive enlargement.
Rarely has a reduction in tumour size been documented
as the patient has grown out of adolescence .
6
CASE REPORT
A 54-year-old male was referred to our clinic with a
Fernandez Martinez long history of recurrent minor epistaxis from right
Service of Otorhinolaryngology of the Burela Coast Hospital, Lugo, Spain
nasal cavity. A posterior plugging and blood transfusion
Diaz Argüello
Service of Otorhinolaryngology of the Sabadell Hospital, Sabadell, Spain was necessary for massive epistaxis in one occasion.
Maseda Alvarez Examination revealed a grey-red lesion in the area
Service of Otorhinolaryngology of the Burela Coast Hospital, Lugo, Spain of nasal septum. The nasopharynx was normal and
Calzada threre was no cervical lymphadenopathy. The suspicion
Service of Anatomy Pathologic of the Burela Coast Hospital, Lugo, Spain
of a vascular neoplasm excluded the need for an
Correspondence: endoscopic biopsy. Computed tomography (CT) and
Jose Antonio Fernandez
Service of Otorhinolaryngology magnetic resonance (MRI) demonstrated a 3 cm mass
Burela Coast Hospital (figures l and 2). Due to the size of the tumour and
C/Rafael Vior, s/n. 27880, Burela, Lugo, Spain.
Telephone number: (+34) 982-58 99 00 the potential haemorrhage we elected to use a lateral
e-mail: jafermar123@hotmail.com
rhinotomy approach. This approach allowed en bloc

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