Nasopharyngeal angiofibroma with intracranial invasion in Canis lupus failiares: Diagnostic challenges and therapeutic limitations

This case report describes a rare and aggressive presentation of a nasopharyngeal angiofibroma in a 6‐year‐old, entire, male Bichon Frise, including its diagnostic and therapeutic challenges. The dog exhibited severe craniofacial deformity, unilateral blindness and persistent nasal bleeding due to an expansile, invasive nasopharyngeal mass measuring 8 × 6 × 5 cm (rostrocaudal × dorsoventral × intraoral protrusion). Skull radiographs and computed tomography yielded expansile bony destruction of the maxilla, skull base and periorbital regions. Histopathology confirmed nasopharyngeal angiofibroma (pseudostratified ciliated epithelium, vascular stroma, a Ki67 index of 5%–15%). Despite antibiotic therapy (meropenem) and antiangiogenic treatment (anlotinib), the tumour showed no response, ultimately resulting in respiratory failure and the death of the patient. This case emphasises nasopharyngeal angiofibroma's locally destructive potential in dogs, highlights the need for multimodal imaging and histopathology for diagnosis, and advocates for early intervention. Very few canine nasopharyngeal angiofibroma cases are documented; this report contributes insights into its clinical behaviour and management limitations.