Juvenile Angiofibroma with Intracranial Extension

The aim of the study was to assess diagnosis and treatment of juvenile angiofibroma with intracranial extension. The group included five boys (10–14 years) with tumor invading skull base. Computed tomography, magnetic resonance imaging, and carotid angiography confirmed diagnosis and demonstrated extensions of the tumor. In three patients the bony walls of the sphenoid sinus and anterior skull base were eroded and tumor was bulging into the cranial cavity. The tumor was removed via the sublabial approach in two patients. For removal of a very extended tumor lateral rhinotomy and for subsequent recurrence the transpalatal approach was used.

Two patients had large tumor extension into the middle cranial fossa laterally to the cavernous sinus. One patient refused surgery and was irradiated (30 Gy) with good result after 3 years of follow-up. For removal of such a tumor in another patient, we used combined infratemporal and sublabial approaches.

Imaging radiography demonstrates well the intracranial extension of juvenile angiofibroma and determines possibilities of surgical removal. Radiotherapy is a reasonable option if surgery is too risky.