HomePhilippine Journal of Otolaryngology Head and Neck Surgeryvol. 25 no. 1 (2010)

Extranasopharyngeal Angiofibroma of the Larynx

Connie Angel J. Trinidad | Michael Joseph C. David | Antonio H. Chua, Md

 

Abstract:

Objective: To present a rare case of laryngeal extranasopharyngeal angiofibroma, discussing its diagnosis, treatment and differences from the more typical juvenile angiofibroma.
Methods:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
Results: A 51-year-old male with a two-year history of hoarseness developed difficulty of breathing. Direct laryngoscopy showed a 2x2x1cm glistening, multinodular, pedunculated, firm, pink mass attached to the posterior half of the right true vocal fold obstructing the glottic opening and extending superiorly to the ventricle. Microlaryngeal excision was done. Histopathology showing numerous vascular channels surrounded by dense paucicellular fibrous tissue was consistent with angiofibroma.
Conclusion: Primary extranasopharyngeal angiofibroma is rare, with only four previously reported cases occurring in the larynx. We presented what may possibly be the first locally reported case. Although histopathologically similar to the more common juvenile nasopharyngeal angiofibroma, this was atypically seen in the larynx of an older adult patient. Direct laryngoscopy provided excellent exposure for identification as well as complete surgical
resection. Unlike the nasopharyngeal type, no massive bleeding was encountered. Prognosis for this extranasopharyngeal angiofibroma is excellent as recurrence is noted to be rare, however, long term follow-up is recommended.