Pirabu Sakthivel, Alok Thakar, Arun Prashanth, Sreedharan Thankarajan Arunraj, Rakesh Kumar, Rakesh Kumar
Somatostatin cell surface receptors are expressed on the peritumoral vessels of various benign and malignant neoplasms including angiofibromas. Positive initial uptake on positron emission tomography-computed tomography (PET/CT) imaging with 68 Ga-labeled DOTANOC is noted in a patient with juvenile nasal angiofibroma (JNA), and the same is noted to be absent following complete surgical excision. Functional 68 Ga-DOTANOC PET/CT may be an early useful tool for JNA residual/recurrence identification and precise postoperative surveillance...
October 2020: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Pirabu Sakthivel, Alok Thakar, Sreedharan Thankarajan Arunraj, Ashu Seith Bhalla, Arun Prashanth, Rakesh Kumar
Somatostatin cell surface receptors are expressed in many different benign and malignant tumors and are often exploited for imaging and therapy of neuroendocrine tumors. A 17-year-old adolescent boy with clinicoradiologically diagnosed JNA (juvenile nasopharyngeal angiofibroma) also underwent 68Ga-DOTANOC PET to explore somatostatin cell surface receptors' expression and its theranostic potential. Fusion PET/MRI, a novel imaging technology, exactly depicted the anatomical extensions of the tumor with avid DOTANOC uptake...
February 20, 2021: Clinical Nuclear Medicine
Alok Thakar, Pirabu Sakthivel, Sreedharan Thankarajan Arunraj, Ashu Seith Bhalla, Arun Prashanth, Rakesh Kumar, Suresh Chandra Sharma, Rakesh Kumar
OBJECTIVES: Juvenile nasopharyngeal angiofibroma (JNA) expresses prostate-specific membrane antigen (PSMA), and PSMA PET/CT scan may be used for its imaging. Also, the precise diagnosis of residual/recurrent JNA after surgical treatment remains difficult with conventional contrast MRI and/or CT; functional imaging with PSMA PET/CT promises greater accuracy in the detection or exclusion of recurrent/residual JNA. PATIENTS AND METHODS: In this prospective study, 22 postoperative JNA patients who underwent a PSMA PET/CT scan both preoperatively and postoperatively from January 2018 to September 2020 were included...
February 20, 2021: Clinical Nuclear Medicine
Piya Rujkijyanont, Chanchai Traivaree, Kantang Satayasoontorn, Apichat Photia, Nawachai Lertvivatpong, Chalinee Monsereenusorn
Background: The most common type of vascular tumors reported among children is hemangioma. The determinant factors to predict clinical outcomes among those patients were not well studied. Objective: The study aimed to explore clinical characteristics and treatment approaches as well as associated prognostic factors of vascular tumors specifically in a pediatric population. Methods: Pediatric patients with a confirmed diagnosis of vascular tumors between January 1, 2005 and December 31, 2017 were enrolled in this study...
2021: Pediatric Health, Medicine and Therapeutics
Nobuyuki Bandoh, Akihiro Katada, Michihisa Kono
A 13-year-old Japanese boy with a 6-month history of bilateral nasal obstruction and a 3-week history of recurrent epistaxis from the right nose was admitted to our department. Nasal endoscopy revealed a reddish, smooth-walled tumor occupying the right nasal cavity. Computed tomography scan revealed a 3.5 × 4.5 × 7.0-cm heterogeneously enhancing mass involving the right nasal cavity and extending posteriorly to the nasopharynx, and laterally to the pterygopalatine fossa and the medial part of the infratemporal fossa...
January 28, 2021: Journal of Craniofacial Surgery
Daniel Salame Waxman, Adelaido López Chavira, Martín Alberto Porras Jiménez, César López Hernández, Jorge Alberto Romo Magdaleno, Julio Eduardo López Montoy
We present a multisystemic approach involving diverse specialists of a rare disease. Bringing into the perspective the importance of multidisciplinary work and complete patient knowledge in order to an adequate clinical practice and patient outcome.
January 2021: Clinical Case Reports
Alok Thakar, Pirabu Sakthivel, Sreedharan T Arunraj, Ashu S Bhalla, Arun Prashanth, Rakesh Kumar, Suresh C Sharma, Rakesh Kumar
OBJECTIVES: Juvenile nasopharyngeal angiofibroma (JNA) expresses different somatostatin cell surface receptors and Ga68 [DOTA, 1-Nal3]-octreotide (DOTANOC)-PET/computed tomography (CT) scan may be used for its imaging. Also, functional imaging with DOTANOC-PET/CT may promise of greater accuracy in the detection or exclusion of recurrent/residual JNA. METHODS: In this prospective study, five JNA patients who underwent a DOTANOC-PET-CT scan both preoperatively and postoperatively during June 2018-March 2020 were included...
January 19, 2021: Nuclear Medicine Communications
Saverio Capodiferro, Luisa Limongelli, Silvia D'Agostino, Angela Tempesta, Marco Dolci, Eugenio Maiorano, Gianfranco Favia
Juvenile nasopharyngeal angiofibroma is a rare vascular neoplasm, mostly occurring in adolescent males, and representing 0.05% of all head and neck tumors. Nevertheless, it is usually recognized as the most common benign mesenchymal neoplasm of the nasopharynx. Usually, it originates from the posterolateral wall of the nasopharynx and, although histologically benign, classically shows a locally aggressive behavior with bone destruction as well as spreading through natural foramina and/or fissures to the nasopharynx, nasal and paranasal cavities, spheno-palatine foramen, infratemporal fossa and, very rarely, to the cranial cavity...
January 1, 2021: Healthcare (Basel, Switzerland)
Salomon Cohen-Cohen, Lucas P Carlstrom, Jeffrey R Janus, Jamie J Van Gompel
Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular benign tumor that originates in the sphenopalatine foramen and often spreads to adjacent compartments.1 Microsurgical resection with preoperative embolization remains the treatment of choice.2 We present a case of a large JNA involving multiple compartments. The patient is a 20-yr-old male who presented with long-term right nasal congestion. The MRI demonstrated a large enhancing mass that extended from the right nasal cavity and nasopharynx into the right pterygopalatine fossa (PPF), infratemporal fossa (ITF), and parapharyngeal space...
December 29, 2020: Operative Neurosurgery (Hagerstown, Md.)
Daniel W Scholfield, Peter Clarke
OBJECTIVES: To describe the midfacial degloving approach and compare the varying surgical approaches to juvenile angiofibromas. To demonstrate the efficacy of midfacial degloving in treating large juvenile angiofibromas in a unique patient cohort. DESIGN: A retrospective case-series between 2006 and 2019. SETTING: All patient care was undertaken at a regional skull base referral centre. PARTICIPANTS: Twenty-one male patients with a median age of 18 (range 16-45 years)...
December 28, 2020: Clinical Otolaryngology
Pirabu Sakthivel, Rakesh Kumar, Sreedharan Thankarajan Arunraj, Ashu Seith Bhalla, Arun Prashanth, Rakesh Kumar, Suresh Chandra Sharma, Alok Thakar
OBJECTIVES/HYPOTHESIS: Somatostatin receptors (SSTRs) are highly expressed in neuroendocrine tumors and is exploited for its imaging and treatment. SSTRs expression is also demonstrated in diverse benign and malignant tumor cell types and proliferating peri-tumoral vessels. Similarly, Juvenile Nasopharyngeal Angiofibroma (JNA) expresses different SSTRs and may be utilized for its imaging and treatment using DOTA, 1-Nal3-octreotide (DOTANOC)-PET/CT scan. STUDY DESIGN: Prospective cohort...
December 23, 2020: Laryngoscope
Gregory Glauser, Donald K Detchou, Michael Kohanski, James N Palmer, Nithin D Adappa, John Y K Lee, Omar Choudhri
No abstract text is available yet for this article.
December 10, 2020: World Neurosurgery
A K Kairo, R Kumar, S C Sharma
Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign tumor of the nasopharynx. For reasons unknown, this tumor is found almost always in male population. However, site of origin of JNA is still an enigma. Previously, JNA was considered to arise from the superior aspect of sphenopalatine foramen. Over last decade, the vidian canal was considered to be the more specific and likely site of origin. However, based on our observations, we believe this hypothesis to be anomalous as it does not explain major blood supply, pattern of skull base erosion in early stage of tumor and newer studies on electron microscopic and immunopathological findings...
November 2020: Medical Hypotheses
Alberto Schreiber, Marco Ravanelli, Marco Ferrari, Davide Mattavelli, Vittorio Rampinelli, Andrea Bolzoni Villaret, Giacomo Bertazzoni, Michele Tomasoni, Tommaso Gualtieri, Ivan Zorza, Davide Farina, Roberto Maroldi, Piero Nicolai
OBJECTIVES/HYPOTHESIS: Despite improvements in the treatment of juvenile angiofibroma (JA), the rate of persistence (pJA) is still not negligible. In the present study, we assessed the value of early postoperative magnetic resonance imaging (MRI) in depicting unintentional pJAs and designed a MRI-driven decisional flow-chart for pJA management and follow-up. STUDY DESIGN: Observational study. METHODS: Patients undergoing early postoperative MRI after endoscopic resection of JA in the Unit of Otorhinolaryngology - ASST Spedali Civili, University of Brescia from 2007 to 2017 were enrolled...
November 27, 2020: Laryngoscope
Janice T Chua, Joseph A Choy, Ronald Sahyouni, Jack L Birkenbeuel, Dillon C Cheung, Edward C Kuan, Naveen D Bhandarkar
Juvenile nasopharyngeal angiofibroma (JNA) is a locally aggressive tumor that predominantly affects adolescent males. Surgical resection is generally considered the standard treatment for both primary and recurrent tumors, regardless of staging. The natural history of these tumors, particularly when untreated or in the setting of residual tumor, is not well characterized. In this article, we report a case of true spontaneous JNA involution. Although the involution of residual tumor after surgical resection has previously been reported, to our knowledge, this is the first documented case of spontaneous JNA involution following a period of tumor growth post-treatment...
November 11, 2020: Laryngoscope
Pirabu Sakthivel, Alok Thakar, Sreedharan Thankarajan Arunraj, Ashu Seith Bhalla, Rakesh Kumar
Prostate-specific membrane antigen (PSMA) is universally expressed in the endothelial cells of tumor-associated neovasculature of juvenile nasopharyngeal angiofibroma. Functional Ga-PSMA PET/CT also enables easier differentiation of the residual tumor from postoperative changes. An 18-year-old man with the residual intracranial disease received radiotherapy after surgery. In PSMA PET/CT imaging, uptake was noted initially only in the residual disease, and the same was absent after successful response to radiotherapy, unlike contrast MRI, which showed persistent enhancement...
November 3, 2020: Clinical Nuclear Medicine
Wilson P Lao, Kristelle J Lagabon, Gabriel A Arom, Paul C Walker, Steve C Lee
Juvenile nasopharyngeal angiofibromas (JNAs) are highly vascular and benign tumors that can expand into the skull base. Delay of treatment can result in intracranial invasion, requiring extensive open approaches such as a facial translocation, maxillary swing, or an orbitozygomatic craniotomy. We describe a single-stage, combined endoscopic and transoral approach on a 14-year-old male with extensive high-stage dumbbell-shaped JNA involving the infratemporal fossa, orbit, buccal space, and intracranial extension into Meckel's cave...
October 28, 2020: Head & Neck
Alok Thakar, Pirabu Sakthivel, Sreedharan Thankarajan Arunraj, Ashu Seith Bhalla, Aanchal Kakkar, Rakesh Kumar, Rakesh Kumar
PURPOSE/BACKGROUND: The specific identification of residual/recurrent juvenile nasal angiofibroma (JNA) following surgical treatment remains difficult. Contrast MRI and CT may not enable the differentiation of tumor from postsurgical reparative tissue. Functional imaging with prostate-specific membrane antigen (PSMA) PET/CT targeting tumor-associated neovasculature has recently demonstrated universal positive uptake in primary JNA and offers promise of greater accuracy in the detection or exclusion of recurrent/residual JNA...
October 16, 2020: Clinical Nuclear Medicine
Avinash Shekhar Jaiswal, Rakesh Kumar, Alok Thakar, Rajeev Kumar, Hitesh Verma, Ashu Seith Bhalla, Arvind Kumar Kairo, Aanchal Kakkar, Suresh Chandra Sharma, Pirabu Sakthivel
BACKGROUND: Juvenile nasopharyngeal angiofibroma is the vascular and locally aggressive tumor of the posterior nares and nasopharynx. Endoscopic excision is the preferred surgical modality in early Radkowski stages. The prime challenge is intraoperative bleeding. Literature is in favor of the use of plasma ablation to overcome surgical challenges. OBJECTIVE: To evaluate the effectiveness of plasma ablation technique in the surgical management of juvenile nasopharyngeal angiofibroma...
September 29, 2020: International Journal of Pediatric Otorhinolaryngology
Stéphane Gargula, Jean-Pierre Saint-Maurice, Marc-Antoine Labeyrie, Michael Eliezer, Clément Jourdaine, Romain Kania, Michel Wassef, Homa Adle-Biassette, Emmanuel Houdart, Philippe Herman, Benjamin Verillaud
OBJECTIVE: Preoperative embolization of juvenile nasopharyngeal angiofibroma (JNA) is usually performed by the occlusion of branches of the external carotid artery (ECA). However, a significant proportion of JNAs also receive blood from the internal carotid artery (ICA). The objective of this study was to report on the feasibility and clinical impact of superselective embolization of ICA branches in complex cases of JNA. METHODS: This was a single-center retrospective study of all patients operated on for JNA between 2000 and 2018...
October 1, 2020: Laryngoscope
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