Angiofibroma In A 50-Year-Old Patient.

Juvenile Angiofibroma (JNA) is a benign tumour that tends to bleed and occur in the nasopharynx with most cases occurring in pre-pubertal and adolescent males 10-20 years. We present the case of a 50-year-old male shopkeeper who consulted the ENT out patients' department (OPD) of Khyber Teaching Hospital (KTH) with the chief complaint of right sided nasal obstruction for the last 2.5 months which was associated with two episodes of epistaxis and diplopia which started 2 months back. He complained of right sided frontal and periorbital pain for the last 15 days. Past medical and surgical history was insignificant. Computerized Tomography (CT) scan without contrast and magnetic resonance imaging (MRI) showed finding consistent with a pedunculated tumour like growth. After baseline investigations, surgery was done and a Wilson's incision was given and the mass was excised and sent to the lab for histopathological report which showed angiofibroma. The age of the patient shows that this is a very rare case of angiofibroma. Dissection of such tumours is important as they have propensity to bleed. Excision along with biopsy is the method of choice. Proper surgical techniques and use of better medical technology are required to make and early diagnosis. Further studies/case reports around the world would assert our findings that a nasopharyngeal angiofibroma can also be found in middle aged men.

Resolution Of Gestational Gigantomastia With Termination Of Pregnancy.

Less than 100 cases of gestational gigantomastia have been described in literature. The aetiology and risk factors are not well-established. Various treatments have been used with some consensus. We present the case of a 47-year-old female who presented to us with bilateral gigantomastia in her 16th week of gestation. She had massively enlarged breasts which were very painful. Relevant laboratory investigations were normal. An incisional biopsy done prior to, and two trucut samples at presentation to us, showed normal breast tissue proliferation. In the absence of adequate pain control, it was decided to electively terminate the pregnancy and give a trial of tamoxifen. She made a rapid recovery following termination without requiring the use of tamoxifen.