A 15-year-old boy presents with recurrent epistaxis, nasal obstruction, and a mass in the nasopharynx. CT scan shows a mass expanding the pterygopalatine fossa with anterior bowing of the posterior maxillary wall (antral sign). The most likely diagnosis is:

• A Juvenile nasopharyngeal angiofibroma ✓
• B Nasopharyngeal carcinoma
• C Antrochoanal polyp
• D Inverted papilloma

Explanation

The antral sign (anterior bowing of the posterior maxillary wall) is a classic CT finding of juvenile nasopharyngeal angiofibroma due to expansion of the pterygopalatine fossa. This occurs in adolescent males with recurrent epistaxis. Nasopharyngeal carcinoma typically presents in older adults with cervical lymphadenopathy and EBV association. Antrochoanal polyp does not cause pterygopalatine fossa expansion. Inverted papilloma arises from the lateral nasal wall, not the nasopharynx.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.