An 18-year-old boy presents with epistaxis and a unilateral nasal mass. The most likely diagnosis is

Question

A 14yr old boy presented with nasal mass and recurrent episodes of bleeding from the mass. Investigation of choice.

Answer 1

This question tests recognition of the classic demographic and presentation of juvenile nasopharyngeal angiofibroma.

Rhinoscleroma: a chronic granulomatous nasal infection with crusting and deformity, not typically a bleeding vascular mass in a teenage boy.
Antrochoanal polyp: causes nasal blockage but is not vascular and rarely causes significant epistaxis.
Rhinosporidiosis: causes a bleeding-prone mass but lacks the strong male-adolescent predilection and vascular skull-base behaviour seen here.
Angiofibroma: classically occurs in adolescent males and presents with a unilateral nasal mass and recurrent brisk epistaxis due to its rich blood supply — the correct answer.

Correct answer: Angiofibroma

Answer 2

This question tests recognition of the classic demographic and presentation of juvenile nasopharyngeal angiofibroma.

Rhinoscleroma: a chronic granulomatous nasal infection with crusting and deformity, not typically a bleeding vascular mass in a teenage boy.
Antrochoanal polyp: causes nasal blockage but is not vascular and rarely causes significant epistaxis.
Rhinosporidiosis: causes a bleeding-prone mass but lacks the strong male-adolescent predilection and vascular skull-base behaviour seen here.
Angiofibroma: classically occurs in adolescent males and presents with a unilateral nasal mass and recurrent brisk epistaxis due to its rich blood supply — the correct answer.

Correct answer: Angiofibroma

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