A patient is suspected of having neuroangiofibroma. Investigation of choice for neuroangiofibroma is?
The juvenile neuroangiofibroma or nasopharyngeal angiofibroma is a lesion of young adolescent males. The presenting symptoms are epistaxis and nasal obstruction foremost, with rarer complaints of proptosis, and involvement of cranial nerves. CT scan of the head with contrast enhancement is now the investigation of choice. It shows the extent of tumor, bony destruction or displacements. Anterior bowing of the posterior wall of maxillary sinus (often called the antral sign or Holman-Miller sign) is pathognomonic of angiofibroma. Ref: Principles of neuro-oncology by David Schiff, 2005, Page 452; Diseases of EAR, NOSE & THROAT By PL Dhingra, 5th edition, 2010, Page 262; Thoracic imaging: a practical approach by Pol J Radiol, 2005, Page 197.
USG
MRI
Contrast enhanced CT scan
Plain CT scan