2025 Poster Presentations
P168: JUVENILE NASOPHARYNGEAL ANGIOFIBROMA (JNA): A SIMPLIFIED RADIOLOGICAL STAGING BASED ON DIFFERENT GROWTH PATTERNS
Douglas Pinheiro Cavalcanti, MD; Fernando Luiz Dias; Marcos Decnop; Terence Pires de Farias; Emilio A. Arteaga; Eduardo Triani Alvarez; Luiza Seganfredo Mainardi; Eduardo Calheiros de Moraes; Pedro Nunes Bernotavicius Araujo; Maria Cristina Traiano Beal; INCA
Objective: Juvenile Nasopharyngeal Angiofibroma (JNA) is an uncommon benign, yet locally aggressive vascular tumor that primarily affects adolescent males. Despite its benign nature, the tumor's aggressiveness can cause significant morbidity due to local invasion of adjacent tissues. This study identifies three distinct patterns of JNA growth and proposes a simplified staging system based upon them.
Methods: A retrospective review was conducted on 16 cases treated at a single cancer institution between 2010 and 2024. We evaluated the efficacy of imaging techniques—computed tomography (CT), magnetic resonance imaging (MRI), and angiography—for both diagnosis and assessing local invasiveness. Three growth patterns were defined: endophytic, lateral, and cranial. Cranial growth was further categorized into exclusive osseous (sphenoidal) and combined osseous and intracranial invasion.
Results: Most cases (10 out of 16) exhibited multidirectional growth involving cranial invasion, while the remaining 6 cases presented with only endophytic tumors.
Conclusion: This work emphasizes the critical role of radiological assessment of tumor invasiveness, proposing a more practical and simplified classification compared with available staging systems found in the literature. Optimal therapeutic strategies depend on the specific growth pattern and may include surgical resection (endoscopic or open, ideally following preoperative embolization), radiation, and/or hormone manipulation.