4.A rare cellular angiofibroma of the epididymis.
Qiang GUO ; Jian-Dong ZHANG ; Li LI ; Jian-Ping XIE ; Ding MA ; Yan-Gang ZHANG
Asian Journal of Andrology 2018;20(1):95-96
5.Juvenile angiofibroma protruding from the nasal cavity.
Voon Hoong Fong ; Mohd Razif Mohamad Yunus
Philippine Journal of Otolaryngology Head and Neck Surgery 2012;27(2):20-23
OBJECTIVE/strong: To describe a case of juvenile angiofibroma with unusual protrusion out of the nasal cavity, and its management with surgery and radiotherapy.br /br /strongMETHODS:/strong br /strongDesign/strong: Case Report br /strongSetting/strong: Tertiary Public Referral Centre br /strongPatient/strong: Onebr /br /strongRESULTS/strong: A 17-year-old gentleman presented with a huge tumor protruding from his left nostril, diagnosed with juvenile angiofibroma stage IlIA by MRI and angiography. Following successful pre-operative embolization, the protruding mass was ligated and truncated, followed by surgical resection via external approach. Post-operative residual tumor was treated with adjuvant radiotherapy. There was no evidence of recurrence after nine months.br /br /strongCONCLUSION/strong: A high index of suspicion is of paramount importance in the diagnosis of JA and avoids the possibility of an unwarranted biopsy which could spell disaster. The most useful tools for diagnosis are MRI and arterial angiography. Treatment is primarily surgical. Irradiation therapy has been reported to achieve satisfactory outcomes, especially for unresectable residual disease and/or intracranial extension, where total surgical resection is unlikely to be attained without unacceptable morbidity./p
Human
;
Male
;
Adolescent
;
Angiofibroma-diagnosis, radiotherapy, surgery
;
Nasopharyngeal Neoplasms
;
neoplasms
;
Magnetic Resonance Imaging
;
Nasal Cavity
;
nose
6.Endoscopic surgery for nasopharyngeal angiofibroma.
Xiang-min ZHANG ; Yi-shu TENG ; Wei-ping WEN ; Qian CAI ; De-le WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2006;41(8):579-582
OBJECTIVETo investigate the efficacy and the surgical techniques of transnasal endoscopic procedure for juvenile nasopharyngeal angiofibroma (JNA).
METHODSTwenty-one nasopharyngeal angiofibroma patients were treated using transnasal endoscopic approach. They were divided into group A (without intracranial extension) and group B (minimal intracranial extension) according to the staging of Sessions. The patients were treated mostly with endoscopic surgery. In two midfacial operations cases, endoscopy was also used. The staging, average blood loss during surgery, tumor residual, and (or) recurrent tumor were evaluated.
RESULTSGroup A (19 cases) had an average blood loss of 1000 ml. Nineteen patients had no residual or recurrent tumor over a follow-up of 8-24 months. Group B (2 cases) had an average blood loss of 1500 ml. One of the patients had minimal residual tumor around the cavernous sinus, but showed no progression over a follow-up of 2 years. Another patient had no residual or recurrent tumor over a follow-up of 8 months.
CONCLUSIONSThe data suggests that transnasal endoscopic surgical techniques can be used to treat JNA which either limited to nasal and nasopharyngeal cavities or and the tumor with sphenoid and ethmoid invasions and even minimal intracranial extension.
Adolescent ; Adult ; Angiofibroma ; surgery ; Child ; Endoscopy ; methods ; Humans ; Male ; Nasopharyngeal Neoplasms ; surgery ; Nose ; surgery ; Retrospective Studies ; Young Adult
7.Resection of nasopharyngeal angiofibroma using by midfacial degloving approach and modified maxillectomy.
Wei SUN ; Xiaoming HUANG ; Yiqing ZHENG ; Jieren PENG ; Hua ZOU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2007;21(24):1134-1139
OBJECTIVE:
To explore the feasibility of treatment on angiofibroma patients with stage III, IV by midfacial degloving approach and modified maxillectomy.
METHOD:
From Feb. 2001 to Aug. 2004, midfacial degloving approach and modified maxillectomy was used for treating 7 angiofibroma patients with stage III, IV. Using Fisch stage: Five cases were in stage III, 2 cases were stage IV; 2 cases with stage III accepted midfacial degloving approach and modified maxillectomy. Five cases accepted midfacial degloving approach and Le fort I approach (stage III, 3 cases; stage IV, 2 cases). One patient accepted the combined therapy of facial approach and cranium approach. 6 cases accept the embolization of the artery which feed the tumor (2 cases in stage IV, 4 cases in stage III).
RESULT:
The blood loss was (600 +/- 324) ml in operation, the blood loss in operation of patients with selective preoperative embolization was (483 +/- 165) ml. The blood loss of one case with no selective preoperative embolization was 1300 ml. The operating time was 129 +/- 22 min. The pathology of 7 cases was nasopharyngeal angiofibroma. For 30 to 72 months follow-up, No tumor recurrence were observed, one case in stage III accepted the selective preoperative embolization got the tumor recurrence 1 year after the surgery. After the second surgery, no tumor recurrence were seen till now.
CONCLUSION
For the patients in stage III, IV, midfacial degloving approach and modified maxillectomy is not only good for radical excision, curtating the operating time and blood loss, but also good for the cosmetic outlook and functional recovery. The selective preoperative embolization has a good significance on reducing the operating blood loss and tumor recurrence rate.
Adolescent
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Adult
;
Angiofibroma
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pathology
;
surgery
;
Child
;
Humans
;
Male
;
Maxilla
;
surgery
;
Nasopharyngeal Neoplasms
;
pathology
;
surgery
;
Neoplasm Staging
;
Retrospective Studies
;
Young Adult
8.Surgical approaches for different stages of nasopharyngeal angiofibromas.
Wei-hong JIANG ; Su-ping ZHAO ; Zhi-hai XIE ; Hua ZHANG ; Jian-yun XIAO
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2007;42(6):417-421
OBJECTIVETo explore the optical surgical approaches for the resection of early and advanced stage of nasopharyngeal angiofibromas.
METHODSTwenty two male patients aged 9 - 30 years (median 16 years) hospitalized in Xiangya Hospital from June 2003 to July 2006 with nasopharyngeal angiofibroma were recruited. Five operative approaches were selected according classification of juvenile nasopharyngeal angiofibroma described by Fisch. Six cases with stage I nasopharyngeal angiofibroma underwent endoscopic transnasal surgery. Six cases with stage II and 2 cases with stage III underwent endoscopic endonasal middle meatal transmaxillary-antrum approach. Three cases with stage III and 2 cases with stage IV underwent endoscopic endonasal middle and inferior meatal approach with extended transmaxillary-antrum resection. One case with stage IV underwent microscopic preauricula infratemporal fossa approaches combined with endoscopic endonasal middle and inferior meatal transantral approach. Two cases with stage IV underwent nasomaxillary osteotomy approach.
RESULTSAfter surgery, CT scan or MR image showed that total removal of the tumor was achieved in 21 patients. One patient who received subtotal resection were performed by second endoscopic surgery and obtained total resection. No postoperative complications have been encountered in all treated patients. Nine months to 3 years follow up indicated that no cases recurred after surgery.
CONCLUSIONSAppropriate surgical approach should be selected according to the clinical classification and whether the tumor has extended into whole nasal cavity, lateral fossa infratemporalis, intracranial or not. Such approaches might better facilitate the complete removal of nasopharyngeal angiofibromas and reduce the surgery-related injury.
Adolescent ; Adult ; Angiofibroma ; pathology ; surgery ; Child ; Endoscopy ; Humans ; Male ; Nasopharyngeal Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Young Adult
9.The reliable treatment choice of nasopharyngeal angiofibroma and causes of operative bleeding.
Gongbiao LIN ; Chang LIN ; Zixiang YI ; Zheming FANG ; Xi LIN ; Wenhui XIAO ; Zhichun LI ; Jinmei CHENG ; Aidong ZHOU ; Shuzhan LAN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(11):770-775
OBJECTIVE:
To introduce the efficacy of three surgical options for juvenile nasopharyngeal angiofibroma (JNA) resection, and causes of operative bleeding.
METHOD:
Retrospective analysis of 36 JNAs,three surgical options were used to resect the tumor. There were 15 cases of Class I tumors , using endoscopic nasal cavity approach. Eighteen cases of class II tumors, via extended Caldwell-Luk incision, using the transantral-infratemporal fosse-nasal cavity combined approach for tumor resection. Three cases of class III tumors, the combined intracranial and extra-cranial approach was used to resect the tumor. Meanwhile, report six typical cases for reference.
RESULT:
Fifteen (15/36) cases of class I tumors, 14 cases were completely resected for the first time without recurrence, 1 recurrence case was re-resected using the same approach. Eighteen (18/36) cases of class II tumors, 13 cases were completely resected for the first time without recurrence, 5 recurrence cases were re-resected totally. Three (3/36) cases of class III were not completely removed, and underwent about 40 Gy radiotherapy with good effects.
CONCLUSION
Using these three surgical options can effectively remove different types of JNA. When necessary, the intracranial residue can use radiotherapy. Under direct vision to separate the tumor, and effective hemostasis play crucial roles for complete removal of the tumor.
Adolescent
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Angiofibroma
;
surgery
;
Blood Loss, Surgical
;
Child
;
Female
;
Humans
;
Male
;
Nasopharyngeal Neoplasms
;
surgery
;
Retrospective Studies
;
Treatment Outcome
;
Young Adult
10.Perioperative managements of huge lobulated nasopharyngeal angiofibromas with intracranial extensions.
Zhichun LI ; Gongbiao LIN ; Lisheng HE ; Zixiang YI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2008;22(14):639-641
OBJECTIVE:
To summarize our experience of successful and failed management in 8 huge lobulated nasopharyngeal angiofibromas with intracranial extensions, and introduce some key points of perioperative treatments.
METHOD:
Eight male case with an average age of 18 years, were all lobes extending into middle and/or anterior cranial fossa, in which 5 cases revealed blood supply from the internal carotid arteries and 3 cases were reoperated because of recurrence. Preoperatively, the tumor were evaluated by CT, CTA, MRI and/or MRA, and super selective embolization of the feeding arteries were crucial procedures. The combined craniofacial approaches were used to excise these tumors.
RESULT:
Five cases were removed completely, and 3 cases were removed partly in which 2 were due to serious bleeding caused by lack of DSA technique at that time and 1 were due to neglecting the tumor lobe in the sphenoid sinus of the other side.
CONCLUSION
Reasonable perioperative management are very important for control of intra-operative blood loss, complete remodeling of the tumor and avoiding complication.
Adolescent
;
Angiofibroma
;
blood supply
;
pathology
;
surgery
;
Brain Neoplasms
;
blood supply
;
secondary
;
surgery
;
Carotid Artery, Internal
;
Humans
;
Male
;
Nasopharyngeal Neoplasms
;
blood supply
;
pathology
;
surgery
;
Neoplasm Invasiveness
;
Treatment Outcome