CT scan pitfalls and angiography’s role in juvenile nasopharyngeal angiofibroma: A case report

Abstract

Diagnosis to treatment of Juvenile Nasopharyngeal Angiofibroma (JNA) required a multidisciplinary approach. CT scan works by combining multi-slice imaging from a device that rotates around the object. The potential of missing certain parts in the scanning process can occur. Angiography was the option to cover the CT scan pitfalls. In this case, we discussed CT scan pitfalls that can be overcome by angiography through JNA case report by showing clearer picture of the JNA and its feeding artery. 14 years old child complained of nasal congestion. On physical examination, the lesion expanded the anterior side of nasal cavity. The patient underwent a synonasal CT scan without contrast. It was obtained a heterogeneous solid mass in the nasopharynx extending to the concha and right and left maxillary sinuses. However, until the preparation of angiography, the actual size of the tumor, as well as the entire vasculature, is not yet known. The angiographic features suggested that the right side (seen in the right maxillary artery) was more dominant than the left side. However, both the right and the left finding reassured that the tumor location was more dominant in the anterior nasal cavity. The posterior lesion was also seen but did not predominate in comparison to the anterior. These findings helped clinicians in planning operative action in order to evacuate the tumor.