International Journal of Pediatric Otorhinolaryngology, 19 (1990) 169- 173 Elsevier 169 PEDOT 00635 Do angiomas of the nasal septum exist? James W. Ochi 2, Donald B. Keams ‘To, Allan B. Seid 1,2, Seth M. Pransky 1*2 and Henry F. Krous ’ I Children’s Hospital and Health Center, San Diego, CA (U.S.A.) and 2 Division of Head and Nech Surgery University of California, San Diego CA (U.S. A.) (Received 14 June 1989) (Revised version received 7 November 1989) (Accepted 10 November 1989) Key words: Juvenile nasopharyngeal angiofibroma zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLK Abstract Juvenile nasopharyngeal angiofibromas (JNA) by definition originate in the nasopharynx. Vascular tumors arising in the nasal cavity can easily be mistaken for JNA, when the correct diagnosis is hemangioma or angiofibromatous polyp. We present a case that illustrates this problem, an 11-year-old boy with a unilateral anterior nasal cavity mass associated with recurrent epistaxis. At surgery, the mass was found to arise from the anterior nasal septum and was removed easily with minimal bleeding. The initial pathologic interpretation was JNA. After extensive review of the specimen, however, the diagnosis of hemangioma was made. Similar tumors have been reported as being JNA that have been simple to remove with minimal blood loss. JNA is associated with more severe blood loss, is more difficult to expose surgically and has a higher risk of recurrence than other nasal tumors. Therefore, JNA needs to be distinguished from anterior nasal cavity masses. Case history The patient is an 11-year-old boy who had progressive increase of a left nasal mass for one month. He suffered occasional pain due to the mass and had an abrupt episode of heavy epistaxis. A magnetic resonance study showed a 2 x 1 cm mass in the anterior nasal cavity; the nasopharynx was clear (Fig. 1). The patient was taken to the operating room where the tumor was noted to originate from the anterior nasal septum. The left inferior and middle turbinates Correspondence: D.B. Keams, 550 Washington Street, Suite 621, San Diego, CA 92103. U.S.A 0165-5876/90/$03.50 0 1990 Elsevier Science Publishers B.V. (Biomedical Division)