A 15-year-old boy with suspected juvenile nasopharyngeal angiofibroma is referred for biopsy of the nasopharyngeal mass. Why is incisional biopsy generally avoided in this tumour?
- A It can precipitate severe haemorrhage because the tumour is composed of vascular spaces lacking a muscular coat ✓
- B It causes dissemination of tumour along the biopsy tract
- C It accelerates malignant transformation of the lesion
- D It induces hormonal acceleration of growth via androgen receptors
Correct answer: A. It can precipitate severe haemorrhage because the tumour is composed of vascular spaces lacking a muscular coat
Explanation
Juvenile nasopharyngeal angiofibroma is a histologically benign but locally aggressive vascular tumour whose blood-filled endothelial-lined spaces lack smooth muscle, so they cannot constrict to achieve haemostasis. Biopsy may trigger torrential, potentially fatal bleeding. Diagnosis therefore rests on clinical features in an adolescent male plus contrast CT and MRI showing the Holman-Miller sign. Malignant transformation does not occur, and hormonal effects do not relate to biopsy trauma.
Reference: Diseases of Ear, Nose and Throat (Dhingra), 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.