Tariq Rafi, Beenish Nisar Ahmed, Muhammad Waqas, Nisar Ahmed.
Nasopharyngeal Angiofibroma with Intracranial Extension; Post Radiotherapy Down Staging and Surgical Excision.
Pak J Otolaryngol Jan ;30(1):24-5.

Nasopharyngeal angiofibroma is a locally aggressive, histologically benign, vascular neoplasm. This neoplasm accounts for 0.05% of head and neck tumors and affects almost exclusively male adolescents. Surgery is considered as the primary treatment of nasopharyngeal angiofibroma. Other treatment modalities such as radiotherapy and chemotherapy are still recommended for intracranial extension involving the cavernous sinus or the internal carotid artery. We report a rare case of nasopharyngeal angiofibroma of stage 4b with intracranial extension. The treatment consisted of radiotherapy and post radiation down staging of tumor. New stage 4a is then treated with surgical excision post angioembolization via lateral rhinotomy approach.We discuss the role of radiotherapy in down staging the tumor and making it possible to excise the tumor effectively in advance stage 4b of nasopharyngeal angiofibromas.

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