juvenile nasopharyngeal angiofibroma

若年性鼻咽腔血管線維腫

WordNet

1. of or relating to or characteristic of or appropriate for children or young people; "juvenile diabetes"; "juvenile fashions"
2. a young person, not fully developed (同)juvenile person
3. of or relating to or located near the nasopharynx

PrepTutorEJDIC

1. 少年少女向きの / 少年の,少女の,若い / 子供じみた,未熟な / 少年,少女 / 子役の俳優

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/19 23:05:18」(JST)

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Nasopharyngeal angiofibroma
Micrograph of a nasopharyngeal angiofibroma H&E stain.
Classification and external resources
DiseasesDB	32229
MedlinePlus	001572
eMedicine	ent/470

Nasopharyngeal angiofibroma (also called juvenile nasopharyngeal angiofibroma) is a histologically benign but locally aggressive vascular tumor that grows in the back of the nasal cavity. It most commonly affects adolescent males. Patients with nasopharyngeal angiofibroma usually present with one-sided nasal obstruction and recurrent bleeding.

Signs and symptoms

• Frequent chronic epistaxis or blood-tinged nasal discharge
• Nasal obstruction and rhinorrhea
• facial dysmorphism ( when locally invasive)
• Conductive hearing loss from eustachian-tube obstruction
• Diplopia, which occurs secondary to erosion into superior orbital fissure and due to third and sixth nerve palsy,
• proptosis when having intraorbital extension.
• Rarely anosmia, recurrent otitis media, and eye pain.

Diagnosis

If nasopharyngeal angiofibroma is suspected based on physical examination (a smooth vascular submucosal mass in the posterior nasal cavity of an adolescent male), imaging studies such as CT or MRI should be performed. Biopsy should be avoided as to avoid extensive bleeding since the tumor is composed of blood vessels without a muscular coat.

Antral sign or Holman-Miller sign ( forward bowing of posterior wall of maxilla) is pathognomic of angiofibroma.

Differential diagnosis

• Antro-choanal polyp (benign neoplasm)
• Rhinosporidiosis (as bleeding point is here too)
• Malignancy—nasopharyngeal carcinoma, lymphoma, plasmacytoma, rhabdomyosarcoma
• Chordoma
• Nasopharyngeal cyst
• Pyogenic granuloma

Treatment

Treatment for Nasopharyngeal angiofibroma ( JNA) is primarily surgical. The tumor is primarily excised by external or endoscopic approach. Medical treatment and radiation therapy are only of historical interest.

External approaches:

• transpalatine approach
• transpalatine + sublabial (Sardana's) Approach
• infratemporal Approach
• nasal endoscopic Approach
• transmaxillary Approach

Endoscopic approach is an excellent tool in primary and recurrent JNA, it allows visualisation and precise removal of the lesion. Preoperative embolisation of tumour may be of some use in reducing intraoperative bleeding.

Prognosis

Prognosis for nasopharyngeal angiofibroma is favorable. Because these tumors are benign, metastasis to distal sites does not occur. However, these tumors are highly vascularized and grow rapidly. Removal is important in preventing nasal obstruction and recurrent epistaxis. Mortality is not associated with nasopharyngeal angiofibroma.

References

External links

• SinusTumor.org—an educational site that provides information about sinus tumors

UpToDate Contents

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• 1. 小児における鼻出血の疫学および病因 epidemiology and etiology of epistaxis in children
• 2. 頭頸部腫瘍の病理 pathology of head and neck neoplasms
• 3. 小児における鼻出血のマネージメント management of epistaxis in children
• 4. 家族性腺腫性ポリポーシスの臨床症状および診断 clinical manifestations and diagnosis of familial adenomatous polyposis
• 5. 遺伝性皮膚症 the genodermatoses

English Journal

• Surgery for juvenile nasopharyngeal angiofibroma with lateral extension to the infratemporal fossa.

• Yamada M1, Tsunoda A2, Tokumaru T1, Aoyagi M3, Kawano Y3, Yano T4, Kishimoto S5.
• Auris, nasus, larynx.Auris Nasus Larynx.2014 Aug;41(4):359-63. doi: 10.1016/j.anl.2014.02.009. Epub 2014 Mar 28.
• OBJECTIVE: The study aimed to assess the usefulness of skull base surgery for large juvenile nasopharyngeal angiofibroma (JNA) with lateral extension to the infratemporal fossa.MATERIALS AND METHODS: Eleven cases were enrolled for this study, and the mean age was 17.7 years old (range: 8-32). Six ou
• PMID 24685728

• Juvenile nasopharyngeal angiofibroma resection: novel technique to improve posterior/inferior margin control.

• Kamat A1, Goldstein GH, Kennedy DW.
• The Laryngoscope.Laryngoscope.2014 May;124(5):1088-9. doi: 10.1002/lary.24391. Epub 2014 Feb 6.
• PMID 24108672

• Stridor: an unusual presentation of juvenile nasopharyngeal angiofibroma.

• Singh HP1, Kumar S, Vashishtha M, Agarwal SP.
• BMJ case reports.BMJ Case Rep.2014 Apr 7;2014. pii: bcr2013202745. doi: 10.1136/bcr-2013-202745.
• Nasopharyngeal angiofibroma is a rare and benign disease, which is mainly found in adolescent male subjects. It is usually diagnosed on clinical grounds on the basis of its presenting symptoms of nasal obstruction, nasal mass and most importantly unprovoked recurrent moderate to severe epistaxis. Im
• PMID 24711471

Japanese Journal

• 鼻内内視鏡による若年性血管線維腫の治療

• 西池 季隆
• 頭頸部外科 24(1), 33-37, 2014
• 若年性血管線維腫は，ほぼ若年男性に発症するまれな良性の血管性腫瘍である。これに対する内視鏡下切除術は，皮切を伴う手術に比較して出血量や合併症は少なく，入院期間も短い。しかし，側頭下窩や海綿静脈洞への過度の浸潤がある場合には外切開アプローチの適応である。術前の選択的血管塞栓療法は有用である。しかし，内頸動脈系の栄養血管の塞栓は困難であり，その対処には2人の術者による3手あるいは4手操作が有用である。 …
• NAID 130004688332

• 若年性鼻咽腔血管線維腫 : 翼突管への進展の評価

• 西池 季隆,識名 崇,前田 秀典,日尾 祥子,猪原 秀典
• 日本耳鼻咽喉科學會會報 115(11), 965-970, 2012-11-20
• 過去3年間にわれわれはJNA手術例を3例経験した. 術前の画像診断では, すべての腫瘍は蝶口蓋孔付近に存在したが, 同時にその翼突管方向への進展と同部の拡大を認めた. 全例で手術に先立ち選択的動脈塞栓療法を行っているが, 1例では内頸動脈系の栄養血管の塞栓は困難であった. 全例で鼻内内視鏡下切除術を行った. 2例は内視鏡単独で切除したが, 残りの1例は犬歯窩切開の併用が必要であった. 術中には内頸 …
• NAID 10031130047

• 内視鏡下経鼻内的に摘出し得た若年性血管線維腫の１例

• 池田 このみ,鴻 信義,青木 謙祐,加藤 孝邦,溝呂木 紀仁
• 耳鼻咽喉科展望 52(3), 166-171, 2009
• 若年性血管線維腫に対する手術療法は, 術中出血の多さや再発の危険性から, 従来外鼻切開法や経上顎洞法, 経口蓋法が選択されてきた。今回我々は内視鏡下経鼻内的に摘出し得た1例を経験した。症例は18歳男性, 中学生の頃から鼻出血と鼻閉を反復していた。他院にて右上顎洞から両側蝶形骨洞へと進展する若年性血管線維腫と診断され当科を紹介された。術前の動脈造影にて腫瘍の主な栄養血管は外頸動脈と考えられたが, 内 …
• NAID 130004911635

Related Links

• Juvenile Nasopharyngeal Angiofibroma - Medscape Reference

7 Feb 2013 ... Juvenile Nasopharyngeal Angiofibroma. Juvenile angiofibroma (JNA) is a benign tumor that tends to bleed and occurs in the nasopharynx of prepubertal and adolescent males.

• Nasopharyngeal angiofibroma - Wikipedia, the free encyclopedia

Nasopharyngeal angiofibroma (also called juvenile nasopharyngeal angiofibroma) is a histologically benign but locally aggressive vascular tumor that grows in the back of the nasal cavity. It most commonly affects adolescent males. Patients ...

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★リンクテーブル★

リンク元	「血管線維腫」「若年性鼻咽腔血管線維腫」
関連記事	「juvenile」「nasopharyngeal」

「血管線維腫」

　　[★]

英

angiofibroma, hemangiofibroma

同

線維性血管腫 fibroangioma

関

若年性鼻咽腔血管線維腫

• 血管内皮細胞と線維芽細胞からなる良性腫瘍であり、年齢によって好発部位がある。若年性のものでは鼻咽頭に好発し、若年性鼻咽頭血管線維腫 juvenile nasopharyngeal angiofibromaと呼ばれる。

参考

• 1. Angiofibroma with oropharyngeal origin

http://pjms.com.pk/issues/aprjun108/article/casereport4.html

• 2.

CT image

http://www.radpod.org/2007/07/06/juvenile-angiofibroma/

• 3.

http://www.jsdi.or.jp/~fumipon/bt/bt.html

国試

• 102A046

「若年性鼻咽腔血管線維腫」

　　[★]

英

juvenile nasopharyngeal angiofibroma

「juvenile」

　　[★]

• adj.

• 若年性の、若年型の、若年の、幼若な、若齢の

関

juvenilis、young

　 　 　

「nasopharyngeal」

　　[★]

• adj.

• 鼻咽頭の、上咽頭の、鼻咽腔の

関

nasopharynges、nasopharynx