Santos-Franco J A, Lee A, Campos-Navarro L A, Tenorio-Sánchez J, Zenteno M, Osorio-Alvarado A R
Department of Neurosurgery and Neurological Endovascular Therapy, Hospital de Especialidades, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social (IMSS), Universidad Nacional Autónoma de México (UNAM); Mexico City, Mexico.
Vasc Endovascular Surg. 2012 Oct;46(7):559-64. doi: 10.1177/1538574412456436. Epub 2012 Aug 17.
Juvenile nasopharyngeal angiofibroma (JNA) is a rare histologically benign tumor, highly vascularized, with usually aggressive behavior, and can extend from the nasal cavity to neighboring structures. We present the case of a 14-year-old male harboring a JNA, presenting with an active severe and persistent epistaxis. Two previous surgical attempts of removal were unsuccessful, because of profuse intraoperative bleeding. Angiography showed a highly vascularized neoplasm with multiple branches arising from both internal carotid arteries, with absence of branches from the external carotid due to previous surgical ligation. Direct puncture tumor embolization was not possible because removal of nasal packing triggered major hemorrhage. The only option for embolization was a technique of non-superselective embolization with particles under transient occlusion of the internal carotid artery. The procedure was performed uneventfully from either side, the tumor was subsequently removed, and the patient had no recurrence 2 years after the initial treatment.
青少年鼻咽血管纤维瘤（JNA）是一种罕见的组织学上为良性的肿瘤，血管高度丰富，通常具有侵袭性，可从鼻腔延伸至邻近结构。我们报告一例14岁男性患有JNA，表现为严重且持续的活动性鼻出血。此前两次手术切除尝试均未成功，原因是术中出血过多。血管造影显示肿瘤血管高度丰富，有多个分支起源于双侧颈内动脉，由于先前手术结扎，颈外动脉无分支。由于取出鼻腔填塞物引发大出血，无法进行直接穿刺肿瘤栓塞。栓塞的唯一选择是在颈内动脉短暂闭塞的情况下用颗粒进行非超选择性栓塞技术。从两侧进行该操作均顺利，随后切除肿瘤，患者在初始治疗后2年无复发。
