Juvenile nasopharyngeal angiofibroma is a rare, histologically benign tumor that is very aggressive and is seen exclusively in adolescent males. These tumors are highly vascularized within the pterygopalatine fossa and have different growth patterns, including possible extension to adjacent tissues and bone destruction by compression, as well as possible intracranial involvement; however, on rare occasions, they can extend beyond the dura. Although there are reports in the literature of nonsurgical therapies, surgery is presently considered to be the ideal treatment. We present a 21-year-old male patient with right nasal obstruction, right unilateral anterior epistaxis, and anosmia for about 3.5 years. A computed tomography scan with contrast of the sinuses showed extension of the lesion to the pterygomaxillary fossa and pterygoid lamina; the lesion was successfully resected endoscopically without embolization of the tumor. An endoscopic approach is effective in the treatment of angiofibromas in their initial stage, with reduced postoperative morbidity. The presentation of this case refers to the efficiency of endoscopic nasal surgery in treating these lesions, without embolization, even in advanced stages of the disease, with acceptable blood loss; not changing endoscopic resection of all tumor and demonstrating that this is a safe alternative for the treatment of nasopharyngeal angiofibroma youth.
