Affiliation:
1. Department of Otorhinolaryngology and Head-Neck Surgery, Medical College and Hospital, Kolkata, India
Abstract
Significance Statement Nasopharyngeal angiofibroma rarely presents in post-adolescent and elderly men, either as the natural evolution of a pre-existing lesion or as a de novo skull-base tumor. As the lesion ages, its composition changes from vessel-predominant to stroma-predominant—the angiofibroma–fibroangioma spectrum. As a fibroangioma, it has restrained clinical features (asymptomatic or occasional epistaxis), minimal avidity for contrast agents, and limited spread potential evident on imaging. These atypical features lead to a diagnostic dilemma when an innocuous choanal/nasopharyngeal fibrovascular mass is encountered in hitherto asymptomatic adult men presenting with epistaxis.