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
N S Grachev, I N Vorozhtsov, S V Frolov, G A Polev, V V Gladko
Juvenile nasopharyngeal angiofibroma (JNA) is a hypervascular, blood-supplied, benign tumour affecting the sinuses, nasal cavity, nasopharynx and the base of the skull. For intraoperative hemostasis, pre-operative embolism is a common and recommended procedure, but it has serious disadvantages, such as additional radiation exposure, anesthesia, and the risk of iatrogenic complications associated with the occlusion of the central artery of the retina, orbital and middle cerebral arteries. This article presents a report on successful radical removal of the widespread SAS without resorting to preoperative embolization, but with intraoperative transnazal endoscopic clipping of the internal maxillary artery (IMA)...
2020: Vestnik Otorinolaringologii
Thomas Hendriks, Katherine Pollaers, Neil Giblett, Latif Kadhim, Ziyad Khaleel, Tim Cooney
No abstract text is available yet for this article.
July 16, 2020: ANZ Journal of Surgery
David Rosenbaum-Halevi, Victor Lopez-Rivera, Ali Turkmani, Aditya Sanzgiri, Hussein A Zeineddine, Amber Luong, Peng Roc Chen
Intra-arterial embolization of juvenile nasopharyngeal angiofibroma (JNA) prior to surgical resection is the preferred approach to minimize blood loss during surgical resection of the tumor. However, the presence of external carotid artery-internal carotid artery (ECA-ICA) anastomoses may hinder complete tumor embolization due to the associated risk for embolic complications. Here, we evaluate the use of a balloon-assisted embolization (BAE) technique in the treatment of JNA. We conducted a retrospective review of JNA patients who underwent tumor embolization with injection of Onyx in a single session between 2013-2018...
June 2020: Journal of Cerebrovascular and Endovascular Neurosurgery
J'undra Pegues, Erin T McCown, Lauren S Buck, Jeffrey D Carron
No abstract text is available yet for this article.
June 16, 2020: Ear, Nose, & Throat Journal
Wilson P Lao, Jordan M Thompson, Lauran Evans, Yohanan Kim, Laura Denham, Steve C Lee
Background: The aim of the study was to present a case of mixed olfactory neuroblastoma (ONB) and carcinoma, an extremely rare tumor with only a few cases in the published literature. Case Description: An otherwise healthy 27-year-old male presented with sinus complaints, headache, and unilateral eye discharge. Imaging and endoscopy revealed a mass presumed to represent a juvenile nasopharyngeal angiofibroma. Unexpectedly, the final pathology report revealed high grade mixed ONB and carcinoma...
2020: Surgical Neurology International
Anupam Mishra, Pankaj Pandey, Subhash Chandra Mishra
BACKGROUND: To study the pattern of olfactory dysfunction/recovery in juvenile nasopharyngeal angiofibroma (JNA). METHODS: Olfactory assessment was undertaken in 30 patients (category1) both pre- & post-operatively and in another 18 (category 2) only postoperative. All patients underwent transpalatal excision and variables of interest included age, radiological stage/parameters & tumor size. RESULTS: Objective olfactory dysfunction was seen in 60% while involvement of olfactory strip was suggested in 50%...
September 10, 2019: American Journal of Otolaryngology
Pirabu Sakthivel, Alok Thakar, Sreedharan Thankarajan Arunraj, Ashu Seith Bhalla, Rakesh Kumar
Prostate-specific membrane antigen (PSMA) is expressed universally in juvenile nasopharyngeal angiofibroma (JNA). As contrast enhancement of postoperative scar is common with contrast-enhanced MRI (CEMRI), diagnosis of residual/recurrent JNA remains perplexing. Prostate-specific membrane antigen PET targets only the neovasculature and may aid in resolving this dilemma. Positive contrast enhancement on CEMRI was noted in a patient after 30 years of initial surgery, simulating recurrence. However, there was no abnormal uptake in PSMA scan, which was confirmed by biopsy as postoperative fibrosis...
May 11, 2020: Clinical Nuclear Medicine
Habib G Zalzal, Meghan T Turner
Endoscopic transmaxillary approaches to remove juvenile nasopharyngeal angiofibromas (JNAs) have been described previously and are used for tumors that extend laterally in the pterygopalatine fossa (PPF) and infratemporal fossa (ITF). There is no previous description of robotic-assisted JNA removal in the literature. The video will demonstrate the success of this technique. Robotic transmaxillary approaches to the lateral PPF and ITF are easily achieved through an extended Caldwell-Luc antrostomy. Total operative time was 519 minutes...
May 4, 2020: Head & Neck
Pirabu Sakthivel, Alok Thakar, Arun Prashanth, Rakesh Kumar, Suresh Chandra Sharma, Rakesh Kumar
Somatostatin (SST) cell surface receptors (SSTRs) are expressed in many different malignant, benign, and neuroendocrine tumors. SSTRs are also expressed in the endothelium of human vessels during angiogenesis and not in the nonproliferating vessels. We present a case of 19-year-old boy with juvenile nasal angiofibroma (JNA), who underwent 68 Ga-DOTANOC PET/CT to explore SSTRs expression and theranostic potential. The scan revealed high uptake in the tumor, and in certain areas, the uptake was similar to that of the pituitary gland...
April 2020: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Indrati Suroyo, Taufik Budianto
Juvenile Nasopharyngeal Angiofibroma is a rare and locally aggressive benign tumor. It is characterized by high vascularization leading to spontaneous bleeding or massive hemorrhage. We reported a case of 13 years old boy with a swollen at the right face, nasal congestion, recurrent nose bleeding, hyposmia, headache, breathing difficulty, and a nasopharyngeal mass at CT scan. Angiography examination showed a highly vascularized mass which was successfully occluded through preoperative embolization procedures...
July 2020: Radiology Case Reports
Pirabu Sakthivel, Alok Thakar, Arun Prashanth, Meivel Angamuthu, Suresh Chandra Sharma, Rakesh Kumar
We present a case of a 16-year-old boy who underwent 68 Ga-PSMA PET/CT for residual disease assessment of juvenile nasal angiofibroma. Positive uptake was noted in residual tumor on PET/CT imaging. However, there was no abnormal uptake in surrounding scar tissues as compared with contrast-enhanced magnetic resonance imaging. These findings were confirmed by biopsy from the scar tissue on posterior ethmoids. 68 Ga-PSMA PET/CT may be a potentially valuable tool especially in distinguishing recurrences from surgical site reparative tissue and in planning and delivering stereotactic radiotherapy...
February 2020: Nuclear Medicine and Molecular Imaging
Alok Thakar, Pirabu Sakthivel, Arun Prashanth, Ashu Seith Bhalla, Suresh Chandra Sharma, Rakesh Kumar
Prostate-specific membrane antigen (PSMA) is expressed in the endothelial cells of tumor-associated neovasculature of various nonprostatic benign and malignant neoplasms including juvenile nasopharyngeal angiofibroma (JNA). Positive uptake on PET/CT imaging with Ga-labeled PSMA is noted in a patient with residual disease after initial surgery without any abnormal uptake in postoperative fibrosis, in contrast to contrast-enhanced MRI, which was confirmed by biopsy. Ga-PSMA PET/CT may be a useful tool clinically for identifying early biochemical recurrences and in specifically differentiating recurrences from surgical site reparative tissue...
February 11, 2020: Clinical Nuclear Medicine
Wiesław Gołąbek, Anna Szymańska, Marcin Szymański, Elżbieta Czekajska-Chehab, Tomasz Jargiełło
INTRODUCTION: This retrospective study analyzes radiological findings, therapeutic management and outcomes of patients with intracranial extension of JNA. The routes of intracranial spread, incidence of intracranial disease and influence on therapeutic approach are discussed. MATERIAL AND METHODS: An evaluation on the records of 62 patients with JNA was performed and 10 patients with intracranial tumors were included in the study. All patients were males aged 10 to 19 years...
October 24, 2019: Otolaryngologia Polska
Pirabu Sakthivel, Alok Thakar, Arun Prashanth, Ashu Seith Bhalla, Aanchal Kakkar, Kapil Sikka, Chirom Amit Singh, Rajeev Kumar, Suresh Chandra Sharma, Rakesh Kumar
PURPOSE: Prostate-specific membrane antigen (PSMA) is highly expressed in prostate cancer cells and is exploited for imaging and treatment of patients with prostate cancer. Prostate-specific membrane antigen expression is also demonstrated in the tumor-associated neovasculature endothelium. Juvenile nasal angiofibroma (JNA), being a similar highly vascular tumor, may also demonstrate significant PSMA expression, which may be utilized for its imaging and treatment. METHODS: In this prospective study, 25 clinicoradiologically diagnosed primary JNA patients underwent PSMA PET/CT scan...
January 17, 2020: Clinical Nuclear Medicine
Karen S Fernández, Alessandro de Alarcon, Denise M Adams, Adrienne M Hammill
Juvenile nasopharyngeal angiofibroma (JNA) is a pathologically benign yet locally aggressive and destructive tumor that develops in the choana and nasopharynx. Historical treatment of JNA has included embolization, surgical resection, and radiation. Here, we describe three patients who received therapy with the mTOR inhibitor sirolimus with improvement in clinical symptoms, imaging, and overall well-being.
April 2020: Pediatric Blood & Cancer
Fetch more papers »
Fetching more papers... Fetching...
Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"