Nasal cavity, paranasal sinuses, nasopharynx
Other tumors
Nasopharyngeal angiofibroma

Author: Nat Pernick, M.D. (see Authors page)

Revised: 23 May 2018, last major update November 2004

Copyright: (c) 2004-2018, PathologyOutlines.com, Inc.

PubMed Search: Nasopharyngeal angiofibroma[TI] free full text[sb]

Cite this page: Pernick, N. Nasopharyngeal angiofibroma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/nasalangiofibroma.html. Accessed August 17th, 2018.
Definition / general
  • Rare tumor, usually adolescent males (10 - 25 years), rarely in older patients or women (may be misdiagnoses)
  • 75% have androgen receptors but not estrogen or progesterone receptors
  • Arises from erectile-like fibrovascular stroma in posterolateral wall of roof of nose
  • May grow into nasopharynx, orbit or cranial cavity
  • May regress after puberty, especially after incomplete surgical excision or radiation therapy
  • Benign but recurs in 40%, usually within one year, particularly if not completely removed
  • Rare sarcomatous transformation after radiation therapy
Treatment
  • Surgery (difficult to excise), preoperative embolization or antiandrogen therapy
  • Chemotherapy or radiation therapy if advanced or aggressive
Gross description
  • Well circumscribed but unencapsulated polypoid fibrous mass, bleeds severely on manipulation and biopsy, may occlude nares
  • Spongy cut surface
Microscopic (histologic) description
  • Intricate mixture of stellate and staghorn blood vessels with variable vessel wall thickness ranging from single layer of endothelium to variable smooth muscle coat
  • Irregular fibrous stroma (loose, edematous to dense, acellular)
  • Stromal cells are stellate fibroblasts with small pyknotic to large vesicular nuclei
  • Larger vessels at base of lesion, smaller vessels with plump endothelial cells at growing edge of tumor
  • Multinucleated stromal cells are common
  • Mitotic figures are rare
  • Minimal inflammation
Positive stains
Electron microscopy description
  • Electron dense granules composed of tightly bound RNA protein complexes
  • Stromal cells are myofibroblasts
Differential diagnosis