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Juvenile angiofibroma

Nasal tumor; Angiofibroma - juvenile; Benign nasal tumor; Juvenile nasal angiofibroma; JNA

Juvenile angiofibroma is a noncancerous growth that causes bleeding in the nose and sinuses. It is most often seen in boys and young adult men.

Causes

Juvenile angiofibroma is not very common. It is most often found in adolescent boys. The tumor contains many blood vessels and spreads within the area in which it started (locally invasive). This can cause bone damage.

Symptoms

Symptoms include:

  • Difficulty breathing through the nose
  • Easy bruising
  • Frequent or repeated nosebleeds
  • Headache
  • Swelling of the cheek
  • Hearing loss
  • Nasal discharge, usually bloody
  • Prolonged bleeding
  • Stuffy nose
Exams and Tests

The health care provider may see the angiofibroma when examining the upper throat.

Tests that may be done include:

Biopsy is generally not recommended due to the high risk of bleeding.

Treatment

You will need treatment if the angiofibroma is growing larger, blocking the airways, or causing repeated nosebleeds. In some cases, no treatment is needed.

Surgery may be needed to remove the tumor. The tumor may be hard to remove if it is not enclosed and has spread to other areas. Newer surgery techniques that place a camera up through the nose have made tumor removal surgery less invasive.

A procedure called embolization may be done to prevent the tumor from bleeding. The procedure may correct the nosebleeds by itself, but it is most often followed by surgery to remove the tumor.

Outlook (Prognosis)

Although not cancerous, angiofibromas may continue to grow. Some may disappear on their own.

It is common for the tumor to return after surgery.

Possible Complications

Complications may include:

  • Anemia
  • Pressure on the brain (rare)
  • Spread of the tumor to the nose, sinuses, and other structures
When to Contact a Medical Professional

Call your provider if you often have:

  • Nosebleeds
  • One-sided nasal blockage
Prevention

There is no known way to prevent this condition.

References

Chu WCW, Epelman M, Lee EY. Neoplasia. In: Coley BD, ed. Caffey's Pediatric Diagnostic Imaging. 13th ed. Philadelphia, PA: Elsevier; 2019:chap 55.

Haddad J, Dodhia SN. Acquired disorders of the nose. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier;2020:chap 405.

Nicolai P, Castelnuovo P. Benign tumors of the sinonasal tract. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 48.

Snyderman CH, Pant H, Gardner PA. Juvenile angiofibroma. In: Meyers EN, Snyderman CH, eds. Operative Otolaryngology: Head and Neck Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 122.

Review Date: 8/12/2019

Reviewed By: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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