Nasopharyngeal Angiofibroma in Adults: Age-Stratified Stage Distribution, Clinical Outcomes, and Exploratory Tumor–Normal Genomics
- 1Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China
Abstract
Background/Objectives: Nasopharyngeal angiofibroma (NA) is generally benign, but recurrent disease and rare malignant transformation remain clinically relevant beyond adolescence. We examined adult clinical presentations, records of malignant transformation, and age-related differences in stage distribution. Methods: We retrospectively reviewed 289 surgically treated patients from January 2006 through June 2026. Radkowski stage distributions were compared between patients aged > 30 and ≤30 years using exact tests. Detailed clinical records were reviewed for 16 adults, and whole-genome sequencing (WGS) annotation summaries were examined for one tumor–blood pair. Results: Twenty-five patients (8.7%) were older than 30 years; stage was available for 287 patients. In the detailed adult subgroup, a prior pathology-slide record described focal malignant transformation with a Ki-67 index of approximately 50% in one recurrent tumor. Two other patients had database transformation entries without accompanying pathological documentation. Four recurrences and three deaths were recorded, all in stage IIIB disease. Three men had colorectal or rectal cancer histories. Low-, intermediate-, and advanced-stage tumors accounted for 36.0%, 36.0%, and 28.0% of adult cases, compared with 17.6%, 57.3%, and 25.2% of younger cases (p = 0.0493). The genomic annotations showed a C>A-predominant substitution spectrum. Conclusions: Adult NA included recurrent stage IIIB disease and a documented record of focal malignant transformation. Stage distributions differed between age groups. These clinical observations support pathological reassessment of recurrent tumors. The single-case genomic findings remain descriptive annotations.
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BibTeX
@article{xu2026nasopharyngeal,
title = {{Nasopharyngeal Angiofibroma in Adults: Age-Stratified Stage Distribution, Clinical Outcomes, and Exploratory Tumor–Normal Genomics}},
author = {Haoyuan Xu and Huankang Zhang and Wanpeng Li and Shixing Zheng and Xiaole Song and Jingjing Wang and Quan Liu and Dehui Wang and Zhuofu Liu},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18193180},
url = {https://www.mdpi.com/2072-6694/18/19/3180},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Nasopharyngeal Angiofibroma in Adults: Age-Stratified Stage Distribution, Clinical Outcomes, and Exploratory Tumor–Normal Genomics
AU - Haoyuan Xu
AU - Huankang Zhang
AU - Wanpeng Li
AU - Shixing Zheng
AU - Xiaole Song
AU - Jingjing Wang
AU - Quan Liu
AU - Dehui Wang
AU - Zhuofu Liu
PY - 2026
DA - 2026/10/02
JO - Cancers
DO - 10.3390/cancers18193180
UR - https://www.mdpi.com/2072-6694/18/19/3180
AB - Background/Objectives: Nasopharyngeal angiofibroma (NA) is generally benign, but recurrent disease and rare malignant transformation remain clinically relevant beyond adolescence. We examined adult clinical presentations, records of malignant transformation, and age-related differences in stage distribution. Methods: We retrospectively reviewed 289 surgically treated patients from January 2006 through June 2026. Radkowski stage distributions were compared between patients aged > 30 and ≤30 years using exact tests. Detailed clinical records were reviewed for 16 adults, and whole-genome sequencing (WGS) annotation summaries were examined for one tumor–blood pair. Results: Twenty-five patients (8.7%) were older than 30 years; stage was available for 287 patients. In the detailed adult subgroup, a prior pathology-slide record described focal malignant transformation with a Ki-67 index of approximately 50% in one recurrent tumor. Two other patients had database transformation entries without accompanying pathological documentation. Four recurrences and three deaths were recorded, all in stage IIIB disease. Three men had colorectal or rectal cancer histories. Low-, intermediate-, and advanced-stage tumors accounted for 36.0%, 36.0%, and 28.0% of adult cases, compared with 17.6%, 57.3%, and 25.2% of younger cases (p = 0.0493). The genomic annotations showed a C>A-predominant substitution spectrum. Conclusions: Adult NA included recurrent stage IIIB disease and a documented record of focal malignant transformation. Stage distributions differed between age groups. These clinical observations support pathological reassessment of recurrent tumors. The single-case genomic findings remain descriptive annotations.
SN - 2072-6694
ER -