An Unusual Case of Angiofibroma at the Base of the Tongue in a Male Child

Angiofibroma is a benign but very aggressive tumor due to its tendency for local invasion. It is composed of myofibroblasts and vasogenic elements, making it a highly vascularized tumor. The oropharyngeal angiofibroma is an atypical angiofibroma in terms of location and symptoms. The general objective of our study was to examine the diagnostic and therapeutic characteristics of an angiofibroma with an exceptional location at the base of the tongue through a case observation accompanied by a literature review. This involves a 13-year-old patient who consulted for solid dysphagia. The onset would date back to 2 years after his admission, marked by the progressive installation of a ronchopathy associated with a feeling of a foreign body in the throat, and firm rhinophonia. This clinical picture prompted traditional treatments based on fumigations, which were unsuccessful. The evolution was marked after 3 months by the addition of solid dysphagia and dyspnea in the supine position. Faced with this clinical picture, they decided to consult us for management. The physical examination revealed a budding mass at the base of the tongue with vascular hyperemia that is mobile during tongue prostration and swallowing, with contact and palpation showing no bleeding or pulsation. A nasofibroscopy objectively showed a submucosal lesion budding at the base of the tongue, mobile during swallowing, extending towards the posterior pharyngeal wall and narrowing the oropharyngeal canal. A computed tomography scan with contrast injection suggested a hyperdense tissue mass, well-circumscribed, developing at the expense of the base of the tongue with significant obstruction of the oropharyngeal tract. The histopathological examination of the operative sample after complete transoral surgical excision under general anesthesia was in favor of an angiofibroma rearranged from the base of the language. The patient was lost to follow-up for 2 years due to financial difficulties as all the medical expenses were borne by the patient without any assistance or health insurance.