A 16-year-old male presents with recurrent unilateral nasal obstruction and profuse epistaxis. Examination shows a smooth pinkish-grey mass in the nasopharynx. CT shows a hypervascular mass centred at the sphenopalatine foramen with extension into the pterygopalatine fossa. Biopsy should NOT be attempted. What is the diagnosis?

• A Nasopharyngeal carcinoma
• B Antrochoanal polyp
• C Juvenile nasopharyngeal angiofibroma ✓
• D Rhabdomyosarcoma of the nasopharynx

Explanation

Juvenile nasopharyngeal angiofibroma (JNA) is a benign but locally aggressive fibrovascular tumour occurring almost exclusively in adolescent males, arising from the sphenopalatine foramen region. The hallmarks are adolescent male, unilateral nasal obstruction, and profuse recurrent epistaxis. Biopsy risks catastrophic haemorrhage; diagnosis is radiological. Preoperative embolisation followed by surgical excision is standard treatment.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.