Spinosi Maria Carla, D'Amico Francesca, Mezzedimi Chiara, Bellan Cristiana, Cirami Manuela, Paganelli Ilaria Innocenti
ENT Clinic, S.M. alle Scotte University Hospital of Siena, Siena, Italy.
Institute of Pathologic Anatomy and Histopathology, University of Siena, Siena, Italy.
J Korean Assoc Oral Maxillofac Surg. 2019 Feb;45(1):43-47. doi: 10.5125/jkaoms.2019.45.1.43. Epub 2019 Feb 26.
The characteristics of extra-nasopharyngeal angiofibromas tend to be different from angiofibromas of the nasopharynx according to patient gender, patient age, prevalence, affected site, pathogenesis, and clinical and epidemiological features. We report a case of an extra-nasopharyngeal angiofibroma in a 28-year-old man referred to the ENT Clinic for right-sided epistaxis, airflow impairment and nasal swelling. The right nostril was completely occluded works by a reddish-yellow mass that bled easily. The computed tomography scan revealed an "inhomogeneous solid lesion in the nasal fossa". With the patient under general anesthesia, the formation in the anterior portion of the right side of the nasal septum was removed up to its vascular base. Although electrical cauterization efficiently controlled the bleeding, we abraded the sub-perichondral area to prevent further bleeding as well as recurrence. The histological exam report confirmed the diagnosis of angiofibroma. As in our case, epistaxis is commonly the presenting sign of angiofibroma. Yet its onset was peculiar, given that the bleeding started with a low impact trauma. The nasal swelling was also a relevant feature as well as the breathing impairment. Although uncommon, nasal septal angiofibromas should considered in patients with epistaxis.
根据患者性别、年龄、发病率、受累部位、发病机制以及临床和流行病学特征，鼻咽外血管纤维瘤的特征往往与鼻咽血管纤维瘤不同。我们报告一例28岁男性鼻咽外血管纤维瘤病例，该患者因右侧鼻出血、气流受限和鼻肿胀转诊至耳鼻喉科诊所。右侧鼻孔完全被一个易出血的红黄肿块堵塞。计算机断层扫描显示“鼻窝内不均匀实性病变”。在全身麻醉下，将鼻中隔右侧前部的肿物切除至其血管基底部。尽管电烧灼有效地控制了出血，但我们对软骨膜下区域进行了刮除，以防止进一步出血和复发。组织学检查报告证实为血管纤维瘤。正如我们的病例一样，鼻出血通常是血管纤维瘤的主要症状。然而，其发病情况较为特殊，因为出血始于一次轻微的创伤。鼻肿胀以及呼吸障碍也是相关特征。尽管鼻中隔血管纤维瘤不常见，但鼻出血患者应考虑到这种疾病。
