Extranasopharyngeal angiofibromas (ENA) are a rare subtype of angiofibromas that exhibit different demography, clinical presentation, differentials and management. We present a case of an extranasopharyngeal angiofibroma that has occurred in the maxillary sinus, as well as review published literature on similar cases.
A 14-year-old male presents with right-sided facial swelling, facial numbness and epistaxis secondary to a vascular lesion occupying the right nasal cavity. Biopsies revealed an angiofibroma. Imaging showed erosion of the anterior maxillary wall, thinning of the anterior wall of the pterygopalatine fossa whilst sparing of the nasopharynx, pterygoid plates and vidian canals. The tumour was excised uneventfully via a right hemi-facial degloving surgery.
Maxillary ENAs presents most often with facial swelling, followed by nasal obstruction and epistaxis. The anterior and medial maxillary sinus walls were more commonly affected. In our case, the posterior and inferior walls were unaffected. These tumours were treated primarily by surgery, and generally will require open surgical approaches. The main differentials of ENAs are angiomatous nasal polyps (ANP) and angiosarcoma.