Neoadjuvant therapy of juvenile angiofibroma of the nasopharynx and base of the skull with good clinical outcome (clinical case)

Abstract

Juvenile nasopharyngeal angiofibroma is a benign, highly vascularized tumor that occurs mainly in children and young men of pubertal age 9-19 years old. Often manifested by difficulty in nasal breathing and nosebleeds. We report a 16-year-old boy with complaints of a complete absence of nasal breathing, nosebleeds, snoring, nasality, exophthalmos on the right side, visual impairment. undergoing therapeutic treatment for rhinosinusitis and adenoid vegetations for 5 months and an unsuccessful attempt at adenotomy in history. When contacting the Department of Oncology and Pediatric Surgery Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology according to imaging with contrast enhancement juvenile angiofibroma of the nasopharynx IVA stage to Fisch-Andrews with a 30 % increase in volume in 2 months. The patient was initiated on neoadjuvant therapy Sirolimus as part of a pilot phase of a prospective clinical trial. After 9 months of taking the drug, there is a reduction in the tumor by 37 %, restoration of vision, clinical and radiological improvement.