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Noncancerous Nose/Larynx Tumours in Childhood

Juvenile Angiofibromas

Juvenile angiofibromas, which occur almost exclusively in boys at puberty, are noncancerous tumors that grow at the back of the nose.

Although this tumor isn't cancerous, it can destroy tissue in the lining of the nose and commonly causes nosebleeds ( epistaxis ). The tumor may also obstruct air flow. As the tumor grows, it may extend into the nearby sinuses, the eye socket, or the area containing the brain (cranial cavity).

A doctor may suspect an angiofibroma when a child has recurring nosebleeds and obstructed breathing. The tumor may be detected by computed tomography (CT) or by magnetic resonance imaging (MRI). The blood vessels supplying the tumor and its possible extension into the eye socket or cranial cavity can be detected by angiography, a type of x-ray in which a radiopaque substance, visible on x-rays, is injected into blood vessels to outline the tumor.

Although an angiofibroma sometimes shrinks as a child gets older, treatment is virtually always necessary. The best treatment is to block the artery supplying the tumor ( angiographic embolization ) and then remove the tumor surgically. However, radiation therapy is sometimes given if the tumor extends into the cranial cavity and can't be removed.

Juvenile Papillomas

Juvenile papillomas are noncancerous tumors of the voice box (larynx).

Papillomas are caused by a virus. Papillomas may appear in children as young as 1 year old. A papilloma may cause hoarseness, sometimes severe enough to prevent speaking, and may obstruct the airway.

The diagnosis is made by using a laryngoscope to view the voice box and is confirmed by performing a biopsy of the papilloma.

Papillomas at several sites may become so big that a surgical procedure to create an opening in the windpipe (trachea) may be needed to make breathing possible. Treatment consists of either surgical removal or laser vaporization of the papillomas. Recurrence is common, but at puberty, the papillomas usually disappear on their own.

From The Merck Manual of Medical Information Home Edition , edited by Mark H. Beers and Robert Berkow. Copyright 1997 by Merck & Co., Inc., Whitehouse Station, NJ:

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