A Rare Presentation of Extra Nasopharyngeal Angiofibroma in the Hard Palate and Maxillary Sinus: A Case Report

Abstract

Background: Juvenile nasopharyngeal angiofibroma (JNA) is a rare, histologically benign but locally aggressive vascular tumor predominantly affecting adolescent males. Extra nasopharyngeal angiofibroma (ENA), a less common subtype, differs significantly in clinical behavior, anatomical distribution, and demographic profile. ENA rarely arises from the hard palate, particularly in pediatric populations.

Case Presentation: We report a rare case of ENA in a 14-year-old male presenting with persistent facial pain and swelling following minor trauma. Clinical examinations revealed facial asymmetry and intraoral swelling without classic symptoms such as nasal obstruction or epistaxis. Imaging demonstrated a destructive soft-tissue mass originating from the left hard palate and extending into the inferomedial maxillary sinus. Complete surgical excision under general anesthesia was performed without the need for preoperative embolization. Histopathological analysis confirmed angiofibroma, and the postoperative course was uneventful with no recurrence at follow-up.

Conclusion: This case highlights an uncommon presentation of ENA in a pediatric patient involving the hard palate with maxillary sinus extension—an exceptionally rare site. Given the atypical symptoms and location, ENA should be considered in the differential diagnosis of pediatric facial masses. Early imaging and histopathological confirmation are key for appropriate management.