Question

20-year-old male patient presents with unilateral nasal obstruction and recurrent bleeding for the past 1 year. Transnasal endoscopic results are shown below. A contrast – enhanced CT revealed a mass extending from the posterior choana to the nasopharynx. What is the most likely diagnosis?

• A. Nasopharyngeal angiofibroma
• B. Antrochoanal polyp
• C. Rhinoscleroma
• D. Concha bullosa

Answer 1

The Correct Option is A

A 20-year-old male patient presents with unilateral nasal obstruction and recurrent bleeding for the past year. A mass extending from the posterior choana to the nasopharynx is observed in a contrast-enhanced CT scan. The symptoms and CT findings strongly suggest a diagnosis of Nasopharyngeal angiofibroma.

This condition typically occurs in adolescent males and is characterized by the following:

• Unilateral nasal obstruction: Common due to the mass effect of the tumor.
• Recurrent epistaxis: Frequent nosebleeds are a classic symptom.
• Location: The mass arises from the nasopharynx, often seen on imaging extending to the posterior choana.

Other options are considered unlikely:

• Antrochoanal polyp: Typically benign and presents with nasal obstruction but not with recurrent bleeding or specific predilection for young males.
• Rhinoscleroma: A chronic granulomatous disease, with nasal obstruction but usually accompanied by infiltration and deformity rather than a singular mass.
• Concha bullosa: An anatomical variant of the nasal turbinate, not presenting as a mass with bleeding symptoms.