Nasopharyngeal angiofibroma

Clinical features

This is an uncommon tumour of the posterior nasal cavity and lateral nasopharynx. patients are almost exclusively males and mostly between 10 and 25 years of age. There is a reported association with familial adenomatous polyposis.

Macroscopic appearances

The tumour is well-circumscribed, lobulated and tan to purple-red.

Histopathology

A collagenised stroma contains numerous irregular blood vessels. The stroma contains spindle to stellate cells, with some multinucleate cells. The vessels at the periphery of the tumour are capillary-like while those at the centre are larger with thick walls.

Immunohistochemistry

	vasculature	perivascular cells	stromal cells
endothelial markers	+
SMA		+	very limited
vimentin			+
CD31	-	-	+
CD34	-	-	+
testosterone receptor			+
oestrogen receptors	negative
progesterone receptors	negative

Differential diagnosis

lobular capillary haemangioma
haemangiopericytoma
solitary fibrous tumour
angiosarcoma

Prognosis

There is a recurrence rate of 20%. After radiotherapy, sarcomatoid transformation has been reported. Rare metastases have occurred.

References

Diagnostic histopathology of tumors. Edited by CDM Fletcher. 2nd edition. Churchill Livingstone.

1Perez-Ordonex B. Special tumours of the head and neck. Current Diagnostic Pathology 2003;9:366-383.

This page last revised 16.1.2004.