Panda Naresh K, Patro Sourabha K, Behera Samarendra, Agarwal Parimal, Das Ashim
Department of Otolaryngology and Head and Neck Surgery, PGIMER, Chandigarh, India.
Department of Histopathology, PGIMER, Chandigarh, India.
Iran J Otorhinolaryngol. 2021 Mar;33(115):107-111. doi: 10.22038/ijorl.2020.40983.2561.
Angiofibromas classically develop in the lateral wall of the nasopharynx from the sphenopalatine region. Extra-nasopharyngeal angiofibromas are rare entities, with the maxillary sinus being the most common site. Parapharyngeal angiofibroma is an extremely rare entity, being seldom reported in English literature.
We present a case of parapharyngeal angiofibroma, which came as a diagnostic surprise in a young adult 25-year-old male. The radiological picture showed a highly vascular lesion, which did draw our attention for not going for a direct or guided FNAC, and upfront excision was planned through the transcervical route. A firm 5 * 7 cm mass was excised and sent for histopathologic examination. The histopathology showed angiofibroma like features as a diagnostic surprise as angiofibroma of parapharyngeal space is a known but rare entity.
The knowledge of angiofibroma as a differential in parapharyngeal space will help the clinicians to properly deal with these disorders during preoperative evaluation and definitive surgery and thus prevent the chances of vascular injuries and complications associated with an FNAC. A high level of suspicion regarding this differential as a possible lesion in the parapharynx is required for the entity's diagnosis.
血管纤维瘤通常起源于蝶腭区域的鼻咽侧壁。鼻咽外血管纤维瘤是罕见的病变，上颌窦是最常见的发病部位。咽旁血管纤维瘤是一种极其罕见的病变，英文文献中鲜有报道。
我们报告一例咽旁血管纤维瘤病例，该病例发生在一名25岁的年轻男性身上，诊断结果令人惊讶。影像学检查显示为高血管性病变，这使我们没有进行直接或引导下细针穿刺抽吸活检（FNAC），而是计划通过经颈途径进行一期切除。切除了一个质地坚硬、大小为5×7厘米的肿块，并送去做组织病理学检查。组织病理学显示为血管纤维瘤样特征，这一诊断结果令人惊讶，因为咽旁间隙血管纤维瘤虽为人所知但很罕见。
了解血管纤维瘤可作为咽旁间隙病变的鉴别诊断，这将有助于临床医生在术前评估和确定性手术期间正确处理这些疾病，从而避免血管损伤以及与细针穿刺抽吸活检相关的并发症。要诊断该病变，需要高度怀疑其为咽旁可能的病变。
