P. Karthikeyan et. al. EXTRA NASOPHARYNGEAL ANGIOFIBROMA OF THE SPHENOID SINUS: A RARE CASE REPORT

Aim: This study aimed to find the effect of preoperative tumor embolization and transnasal endoscopic excision of a sphenoid sinus angiofibroma on the postoperative outcome. Case Report: A thirteen year old male presented to the Outpatient ENT Department of a tertiary care centre, with a history of recurrent left-sided spontaneous painless epistaxis since one year. Diagnostic Nasal Endoscopy showed a pink globular mass seen occupying the left choana and extending into the left nasal cavity. CT Paranasal sinuses (Plain and Contrast) revealed a well-defined moderately enhancing soft tissue lesion seen predominantly at the base of sphenoid sinus on the left side, extending into the choanal region with destruction of the base of the sphenoid bone. Patient underwent Diagnostic Angiography in view of pre-operative embolisation and the patient later underwent embolisation of feeder artery supplying the massusing Gelfoam. Subsequently the patient underwent Transnasal Endoscopic Excision of the tumour under general anaesthesia and the specimen was sent for histopathological examination, which revealed features suggestive of Angiofibroma. Discussion: Extranasopharyngealangiofibromas are vascular fibrous nodules occurring outside the nasopharynx and are rare, benign neoplasms characterized by a different biological history and clinical features with respect to nasopharyngeal tumours, and for these reasons, should be regarded as a separate clinical entity. Conclusion: Although it sometimes involves the sphenoid sinus, angiofibroma rarely originates from this site and only five such cases have been reported in the literature.