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A Rare Case of a Second Primary Nasopharyngeal Angiofibroma

Objective: 1) Present what is to our best knowledge the first reported case of a patient with a contralateral second primary angiofibroma. 2) Discuss the details of the clinical presentation, workup, and management of this patient. Method: This is a case report of a 24-year-old man presenting with a contralateral second primary angiofibroma 5 years after endoscopic removal of the primary tumor. His medical charts from 2005 until present time were reviewed. Results: Nasopharyngeal angiofibromas can receive their blood supply from bilateral carotid systems. Also, a case of a patient with bilateral angiofibromas was previously reported in the literature. Our case is different in that it deals with a contralateral second primary angiofibroma. Before endoscopic removal of the first angiofibroma, angiography confirmed that its main feeder came from the ipsilateral internal carotid artery system. When the tumor recurred it involved the contralateral external carotid system. With all these factors considered, we excluded the possibility of this being a case of recurrent angiofibroma, even though this possibility was originally considered. Conclusion: We present a case of a contralateral second primary angiofibroma diagnosed 5 years after endoscopic removal of the original primary tumor. This is to our knowledge the first case of such nature reported in the English literature.