A 14-year-old boy presents with unilateral nasal obstruction (right side) and progressive epistaxis. CT scan shows a lobulated, intensely enhancing mass centered at the sphenopalatine foramen. The most likely diagnosis and its treatment are:
- A Ethmoidal polyp — managed by topical corticosteroids and FESS
- B Inverting papilloma — managed by medial maxillectomy
- C Juvenile nasal angiofibroma (JNA) — managed by preoperative embolisation followed by endoscopic resection ✓
- D Nasopharyngeal carcinoma — managed by primary chemoradiotherapy
Correct answer: C. Juvenile nasal angiofibroma (JNA) — managed by preoperative embolisation followed by endoscopic resection
Explanation
An adolescent male with unilateral nasal obstruction, recurrent epistaxis, and an intensely enhancing vascular mass at the sphenopalatine foramen is pathognomonic for Juvenile Nasal Angiofibroma (JNA). It is a benign but locally aggressive fibrovascular tumor. Standard management is preoperative selective embolisation of feeding vessels (usually internal maxillary artery branches) 24–48 hours before endoscopic or combined surgical resection to minimise intraoperative bleeding.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.