TUMOR-INFILTRATING IMMUNE CELLS IN NASOPHARYNGEAL ANGIOFIBROMA: SURGICAL MANAGEMENT AND IMMUNOHISTOCHEMICAL ANALYSIS

Nasopharyngeal angiofibroma is a benign but locally aggressive tumor of unknown etiology, typically occurring in the nasopharynx of male adolescents. A 21-year-old male patient was referred presenting left facial swelling and a nodular lesion arising from the upper vestibule. The imaginologic analysis showed a large mass occupying the left maxillary sinus. After incisional biopsy, microscopy exhibited a prominent vascular component constituted by vessels of variable size and shape, supported by cellular stroma, as well as collagenized and fibromyxoid areas. Immunohistochemistry showed positivity for vimentin, α–smooth muscle actin, and CD34 and focally for D2-40, desmin, and CD10. Moreover, CD68, CD163, FXIIIA, and CD209 highlighted numerous tumor-infiltrating immune cells, either macrophages or dendritic cells. The Ki-67 was 3%. The Weber Ferguson approach was used to remove the whole lesion. Besides growth factors and androgen receptors, the role of tumor-infiltrating immune cells in nasopharyngeal angiofibroma tumorigenesis should be clarified.