Aggressive Juvenile Angiofibromas

Materials and Methods: Two case reports of patients presenting with nasal obstruction epistaxis found to have masses of the skull base with unusual amount of bone erosion found to represent juvenile angiofibromas.

Discussion: Angiofibromas may originate in the nasopharynx or the pterygomaxillary area. They often cause local bone destruction but with extension into the sinuses. Extensive bone involvement suggests more rapidly expanding aggressive tumors.

Conclusions: In young males, the presence of mass lesions involving either primarily or secondary the paranasal sinuses may represent juvenile angiofibroma. Because of dual supply, it is essential that original surgery be performed to remove the major supply of the pterygomaxillary artery, but also to make sure that no additional supply off the internal carotid artery, particularly to the cavernous sinus branches is taken care of.