Unusually Large Extranasopharyngeal Angiofibroma of the Infratemporal Fossa: A Rare Case Report
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CASE REPORT
Unusually Large Extranasopharyngeal Angiofibroma of the Infratemporal Fossa: A Rare Case Report Jagadish Chandra1 • Vinayakrishna K1 • Husain Dhabaria1
•
Riaz Abdulla2
Received: 30 June 2020 / Accepted: 17 September 2020 The Association of Oral and Maxillofacial Surgeons of India 2020
Introduction Angiofibroma is a benign, locally aggressive, fibrovascular neoplasm with distinctive morphological and clinical features. They virtually always arise from the nasopharynx in the region of the sphenopalatine foramen and pterygopalatine fossa and termed as nasopharyngeal angiofibroma (NA). Though it is the most common benign neoplasm of the nasopharynx, it accounts for only 0.05–0.5% of all head-and-neck neoplasms [1]. Angiofibromas have been sporadically described in extranasopharyngeal sites. The infratemporal fossa is an uncommon location, and only 7 cases have been reported [2]. The clinical characteristics of extranasopharyngeal angiofibroma (ENA) do not conform to that of NA, thus diagnostically challenging. Here, we present a case of ENA involving the infratemporal fossa presenting as a painless swelling of the cheek.
Case Report • A 24-year-old male patient presented to the Oral and Maxillofacial Surgery OPD with a complaint of slow growing, painless, swelling over the left side of his face
& Husain Dhabaria [email protected] 1
Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Yenepoya (Deemed To Be University), Mangaluru, India
2
Department of Oral Pathology and Microbiology, Yenepoya Dental College, Yenepoya (Deemed To Be University), Mangaluru, India
in the cheek region for the past 3 and a half years. He reported a progressive increase in the swelling. There was no history of fever, dysphagia, or difficulty in breathing. There was no history of trauma; no other skin lesion was present. • On extraoral inspection, a diffuse swelling extending antero-posteriorly from left nasolabial fold till 1 cm anterior to the posterior border of the mandible and supero-inferiorly from the left temporal region till 1 cm above the inferior border of the mandible was seen with the overlying skin appearing normal (Fig. 1). Palpation revealed a firm, non-tender, non-fluctuant, non-mobile swelling with no local rise in temperature, and the skin over the swelling was pinchable. There was no regional lymphadenopathy. Intraorally, swelling was seen in respect to left buccal mucosa with an obliteration of maxillary vestibular fold from 25 to 28 region without any occlusal derangement or restriction in mouth opening. • Contrast-enhanced computed tomography (CECT) imaging of the head and neck region was suggestive of a well-defined, homogenous, enhancing soft tissue lesion in the left infratemporal fossa: superiorly, extending to the temporal fossa, and inferiorly, into the buccal space. The lesion is seen causing anterior bowing of the posterior wall of the maxillary sinus (Holman–Miller sign) with minimal intra-orbital extension through the inferior orbital fissure with no obvious des
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