Atypical angiofibromas: a report of four cases

In this study, our four patients with angiofibroma with various atypical features are presented. Related literature is reviewed and criteria for atypicality are proposed. 14 patients, diagnosed and treated for angiofibroma in the Otorhinolaryngology Department of Faculty of Medicine in Uludag University between January 1992 and December 2003, have been evaluated. The files of the patients were examined and four patients with atypical characteristics have been included in the study. Angiofibromas presenting with at least one of the following criteria such as origin or location other than nasopharynx, presenting complaints other than nasal obstruction or epistaxis, aged younger than seven or older than 25, female sex, atypical histopathology and multifocalitiy were considered as “atypical”. Four of 14 angiofibromas (28.5%), which were diagnosed and treated in our clinic, had atypical features. The reasons for atypicality were unusual localization in three patients and uncommon initial symptom in one case. In the atypical localization group, neoplasm was located in tonsil in one case, and in inferior turbinate in two patients. The only patient with atypical initial symptom presented with a bulging in the cheek. The patients, who have different characteristics other than classical angiofibromas, may be called “Atypical Angiofibroma (AAF)”, under the scope of the related literature and our experience. These patients should be included in atypical group according to the characteristics such as, localization, symptom, age, sex, histopathology and multifocality.