Case 2: Nasopharyngeal Angiofibroma
A 24 year old male presented with complaint of left nasal obstruction with history of profuse epistaxis for 2 years. CT scan showed classical ‘Holman Miller’ sign of forward bowing of the posterior maxillary wall and was reported as an angiofibroma with extension towards the pterygopalatine fossa.
The mass was removed by Weber-Ferguson approach.
Figure 1: Axial CT Scan of Nasopharyngeal Angiofibroma Click on Pictures to Enlarge
Figure 2: Axial CT Scan of Nasopharyngeal Angiofibroma Click on Pictures to Enlarge
The histopathological report showed vascular spaces of varying caliber lined by endothelial cells, devoid of muscle layer separated by loose fibrous tissue and proved the mass to be angiofibroma (see Figure 4). This case was especially challenging in view of the need for complete removal despite its extension to the sphenoid sinus and poor direct access.