ANGIOFIBROMA WITH ATYPICAL LOCALIZATIONS IN EARLY-CHILDHOOD

Angiofibromas are usually characterized by their occurences in adolesc ent males with a typical localization and involvement of the posterior nasal cavity and nasopharynx. Even the suspicion of an extranasophary ngeal angiofibroma or an angiofibroma in young children must be viewed in general with skepticism, although reports of angiofibromas with at ypical localizations and manifestations in young children have appeare d in the literature. Three cases of this fibro-vascular neoplasm with manifestations in the first decade of life and atypical localizations are presented: (1) an angiofibroma medial to the left lacrimal sac in a 15-month old boy, (2) a right paranasal localization in a 9-year-old boy and (3) an angiofibroma limited to the right sphenoid sinus in a 6-year old boy. In all three cases the neoplasm was resected via an en donasal, micro-endoscopic approach that avoided an external incision. According to the literature and based on our own experiences with typi cal histological findings in all three cases, the clinician has to be aware that the rare angiofibroma can occur in preadolescent children w ith atypical localizations. The endonasal surgical approach is without any doubt the least traumatic one and in selected cases allows resect ion of a circumscribed tumor considering functional and aesthetic aspe cts.