Angiofibroma Arising from the Uncinate

Abstract

Objective: 1) Report the case of a nasal angiofibroma that presented in an unusual location in an adult patient. 2) Review the available literature on nasal angiofibroma, with a focus on atypical presentations.

Method: An adult male presented with left-sided nasal obstruction. Examination revealed a polypoid mass obscuring the middle meatus. Intraoperatively, the mass appeared to originate from the uncinate process. Minimal bleeding was encountered. Pathology revealed nasal angiofibroma. Three months postoperatively, he is free of disease.

Results: This represents a rare presentation of nasal angiofibroma, which is a primarily nasopharyngeal lesion seen in adolescent males. Review of the literature confirmed this. The most common atypical locations were the middle and inferior turbinates. No cases of angiofibroma arising from the uncinate process were previously reported. Angiofibroma is a highly vascular tumor, frequently requiring preoperative embolization. In this case, however, we did not embolize preoperatively and did not encounter significant bleeding. Endoscopic technique is becoming more common for excision of nasal angiofibromas. We were able to completely excise the tumor using an endoscopic approach.

Conclusion: Nasal angiofibroma is a rare tumor presenting predominately as a nasopharyngeal lesion in adolescent males. Uncommonly, this tumor presents in adults or in varying locations within the nose. Angiofibroma should be included in the differential diagnosis of atypical nasal masses. These patients require close follow-up given the propensity for recurrence.