Juvenile nasopharyngeal angiofibroma (JNA) is a rare, noncancerous tumor that forms in the back of the nose, in an area called the nasopharynx. Although JNA is not cancer, it can grow into nearby tissues and cause serious symptoms if it is not treated.
JNA is a benign vascular tumor, which means it contains many blood vessels. Because of this rich blood supply, the tumor can bleed easily and cause frequent nosebleeds.
JNA most often affects teenage males, usually between ages 10 and 20. Experts do not fully understand why, but hormones that increase during puberty may play a role.
Early diagnosis is important. As the tumor grows, it can block the nasal passages and spread into nearby areas such as the sinuses, eye socket or skull base.
The nose and nasal passages help your child breathe. They also warm, moisten and filter the air before it reaches the lungs.
Behind the nose is the nasopharynx. This area connects the nasal cavity to the throat and helps air move through the upper airway.
Healthy tissues and blood vessels allow these structures to work normally. When JNA develops, it can block airflow and affect normal breathing and sinus drainage.
Juvenile nasopharyngeal angiofibroma often starts as a small growth in the nasopharynx. Over time, it may grow and spread into nearby spaces. Doctors look at the tumor’s size, location and spread when planning treatment.
Tumor size is not the only factor that affects symptoms. The tumor’s location and how far it has spread also matter. As the tumor grows, it can block one or both nasal passages. This often causes ongoing congestion and difficulty breathing through the nose.
Because the tumor contains many blood vessels, even minor irritation can lead to heavy bleeding.
The exact cause of juvenile nasopharyngeal angiofibroma is not known.
Researchers believe male hormones called androgens may influence tumor growth because JNA occurs most often in teenage males. Abnormal development of blood vessels in the nasopharynx may also play a role.
Scientists continue to study possible genetic and molecular factors that could contribute to the condition. More research is needed to fully understand why JNA develops.
Symptoms usually develop slowly as the tumor grows. The most common signs include:
Larger tumors can sometimes cause:
Talk with your child’s doctor if your child has frequent nosebleeds, ongoing nasal blockage or trouble breathing through their nose.
After referral, an ear nose and throat (ENT) doctor will begin with a medical history and physical exam. They will ask about symptoms such as nosebleeds, congestion and breathing problems.
A nasal endoscopy in the office is often used to look inside the nose and nasopharynx. Before the procedure, the nasal cavity is sprayed with numbing medicine. Then a thin tube with a light and camera is inserted through the nose to help doctors see the tumor. The tumor looks like a smooth, reddish or purplish mass located at the back of the nasal cavity. The endoscopy takes just a few minutes and is not painful, but it may be uncomfortable.
If the endoscopy shows a tumor, doctors usually order a CT scan and MRI scan. The scans help doctors better see the tumor's size, location and whether it has spread into nearby structures before treatment is planned.
During these tests, the patient lies still on a table while detailed images of the head and nasal passages are taken. Doctors may give contrast dye through an IV to help make the tumor and its blood vessels easier to see.
Doctors usually do not do a biopsy (taking a tissue sample) for JNA because the tumor has many blood vessels and can bleed heavily.
Treatment depends on the size of the tumor and whether it has spread into nearby structures.
Surgery is the main treatment for most children with juvenile nasopharyngeal angiofibroma. Many tumors can be removed using minimally invasive endoscopic techniques through the nose.
Before JNA treatment, doctors may perform an angiogram. This test shows the blood vessels that feed the tumor. This test is done under general anesthesia a few days before the tumor is removed. A pediatric neurointerventionalist is the type of doctor who does this test. During the procedure, doctors often block some of the tumor’s blood supply to help reduce bleeding during JNA surgery. This is called embolization.
In some cases, doctors use radiation therapy instead of surgery to treat JNAs. Radiation therapy uses focused energy beams to shrink or control the tumor. It is used for tumors that cannot be safely removed with surgery or have extended into a difficult area, such as the skull base. It is also used if part of the tumor remains after surgery or if the tumor comes back after treatment. This is called JNA recurrence.
The care team creates an individualized treatment plan based on each child's needs.
Most children stay in the hospital for monitoring after surgery. The length of the stay depends on the complexity of the procedure and the child's recovery. For endoscopic surgery, the stay is about one to three days in the hospital. For more extensive surgery with larger tumors or skull-base involvement, the stay may be three to seven days.
Doctors watch closely for bleeding, infection and other complications. Pain is usually managed with medication and supportive care. Full recovery at home usually takes several weeks.
Most children gradually return to school, sports and other normal activities as they heal.
Some tumors can come back after treatment. The risk of recurrence is higher with larger tumors or tumors that extend into complex areas near the skull base. Regular follow-up care helps doctors find and treat any recurrence early. For this reason, many children need imaging studies for several years after treatment.
The outlook for children with juvenile nasopharyngeal angiofibroma is generally very good.
Most tumors can be treated successfully with surgery. Advances in imaging, embolization and endoscopic surgery have improved outcomes and reduced complications.
Typically tumors stop growing and the risk of recurrence decreases when the child has completed puberty.
Many children go on to live healthy, active lives with few long-term effects.
Recovery can take time, especially after major surgery. Families can help by encouraging rest, attending follow-up appointments and following the care team's instructions.
Teenagers may need emotional support while coping with a diagnosis, treatment and recovery. Open communication and support from family, friends and healthcare providers can help.
Ongoing monitoring is important to make sure the tumor does not return.
No. JNA is a noncancerous nasal tumor. But it can grow into nearby tissues and cause serious problems if it is not treated.
Researchers are not completely sure. Male hormones called androgens may contribute to tumor growth, which may explain why JNA occurs most often in males.
Many children only need one surgery. But some children with larger or more complex tumors may need additional procedures.
Yes. JNA can recur, especially when tumors are large or involve nearby structures. Regular follow-up visits help doctors monitor for recurrence.
Follow-up schedules vary. Most children need regular exams and imaging studies for several years after treatment to watch for signs of recurrence.
Surgery is generally safe when performed by experienced specialists. Preoperative embolization and advanced surgical techniques help reduce the risk of bleeding and other complications.
Contact your child's doctor if they have severe nosebleeds, worsening nasal blockage, vision changes, facial swelling or any new symptoms after treatment.
Last Updated 10/2026
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