This case was unusual in that here the boy presented at the age of 33 years with a history of left side nasal bleed for last one years. To prove it to be a case of Angiofibroma, I took biopsy under local anesthesia. luckily, since the tumour mass was occluding the choanea, it did not bleed into oropharynx. Biopsy showed thick angiod element with final inference of benign vascular growth. DSA showed it to be getting supply from both internal maxillary artery and left ascending pharyngeal artery which were embolized by PVA particle.
The case was operated upon by team of Dr. Atul Jain, Dr. Ajay Jain and Dr. Poonam Gautam at Pushpanjali Crosslay Hospital. A Transpalatal approach was used as shown in first figure. It bled a lot but no transfusion was required. The final histopathological examination of specimen confirmed it to be Angiofibroma.