Juvenile nasopharyngeal angiofibroma occurs almost exclusively in adolescent males. This striking sex predilection is explained by:

• A X-linked inheritance of the causative mutation
• B Higher levels of circulating oestrogen in pubertal females causing regression
• C Androgen-dependent growth of the tumour expressing testosterone receptors ✓
• D Association with male-limited precocious puberty

Explanation

JNA cells express androgen receptors, and testosterone is believed to drive tumour growth during puberty, explaining the near-exclusive occurrence in adolescent males. This hormonal dependence underlies historical trials of anti-androgen therapy such as flutamide. There is no X-linked mutation, oestrogen does not cause regression in females, and the tumour is unrelated to precocious puberty syndromes.

Reference: Scott-Brown's Otorhinolaryngology Head and Neck Surgery, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.