Juvenile Nasopharyngeal Angiofibroma With Skull Base Involvement: A Radiological and Clinical Insight Into a Classic Adolescent Presentation

Juvenile nasopharyngeal angiofibroma (JNA) represents a rare, histologically benign yet locally aggressive vascular tumor that predominantly arises in adolescent males. Given its propensity for invasive growth and involvement of critical anatomical structures, precise radiological evaluation is vital prior to any intervention. We present the case of a 13-year-old male who experienced progressive bilateral nasal blockage and recurrent epistaxis predominantly on the left side. Magnetic resonance imaging (MRI) identified a vividly enhancing lesion centered at the left sphenopalatine foramen, with extensions into adjacent sinuses, the pterygopalatine fossa, infratemporal fossa, and early skull base erosion. This case highlights the critical diagnostic and staging role of MRI in JNA, illustrating how characteristic imaging findings inform diagnosis, classification, and surgical planning.