High-grade malignant transformation of a radiation-naïve nasopharyngeal angiofibroma

Jordan J. Allensworth, Scott Troob, Christian Lanciault, Peter Andersen

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Nasopharyngeal angiofibromas are typically considered benign vascular neoplasms, with descriptions of high-grade sarcomatous change found only in lesions with prior radiotherapy. Methods and Results: We describe the first reported case of high-grade malignant change in a nasopharyngeal angiofibroma naive to radiation. A 45-year-old man presented with left-sided nasal congestion and fullness and was found to have a left-sided nasopharyngeal mass with intracranial extension on CT scan. A biopsy of the mass revealed nasopharyngeal angiofibroma. The patient opted for MRI surveillance, which revealed interval growth 3 years later. Decompression surgery revealed only angiofibroma, but resection 9 months later demonstrated high-grade sarcoma and concomitant angiofibroma. The patient had residual disease which progressed through chemoradiation, and is now pursuing clinical trial enrollment. Conclusion: Malignant transformation of nasopharyngeal angiofibroma is extremely rare. As highlighted by this report, high-grade undifferentiated lesions may arise in tumors without previous radiation.

Original languageEnglish (US)
JournalHead and Neck
DOIs
StateAccepted/In press - 2016

Fingerprint

Angiofibroma
Radiation
Vascular Neoplasms
Decompression
Nose
Sarcoma
Neoplasms
Radiotherapy
Clinical Trials
Biopsy
Growth

Keywords

  • Adult angiofibroma
  • Malignant transformation
  • Nasopharyngeal angiofibroma
  • Radiation naive
  • Undifferentiated sarcoma

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

High-grade malignant transformation of a radiation-naïve nasopharyngeal angiofibroma. / Allensworth, Jordan J.; Troob, Scott; Lanciault, Christian; Andersen, Peter.

In: Head and Neck, 2016.

Research output: Contribution to journalArticle

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N2 - Background: Nasopharyngeal angiofibromas are typically considered benign vascular neoplasms, with descriptions of high-grade sarcomatous change found only in lesions with prior radiotherapy. Methods and Results: We describe the first reported case of high-grade malignant change in a nasopharyngeal angiofibroma naive to radiation. A 45-year-old man presented with left-sided nasal congestion and fullness and was found to have a left-sided nasopharyngeal mass with intracranial extension on CT scan. A biopsy of the mass revealed nasopharyngeal angiofibroma. The patient opted for MRI surveillance, which revealed interval growth 3 years later. Decompression surgery revealed only angiofibroma, but resection 9 months later demonstrated high-grade sarcoma and concomitant angiofibroma. The patient had residual disease which progressed through chemoradiation, and is now pursuing clinical trial enrollment. Conclusion: Malignant transformation of nasopharyngeal angiofibroma is extremely rare. As highlighted by this report, high-grade undifferentiated lesions may arise in tumors without previous radiation.

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