Astroblastoma in a Young Female Patient: A Case Report and Literature Review of Clinicopathological, Radiological and Prognostic Characteristics and Current Treatment Strategies

Astroblastoma is an uncommon glial tumor with predominant manifestation in the young age. Herein, we report a case of 18-year-old astroblastoma female patient who presented with history of two months headache. Magnetic resonance imaging (MRI) of the brain demonstrated well circumscribed, intra-axial abnormal signal intensity lesion (size=5×4 cm²) in the right parieto-occipital region of the brain. The patient underwent complete surgical resection of the gross tumor, as confirmed by an early post-surgical MRI (i.e., within 24 hours of surgery). Histopathological examination revealed neoplastic lesion exhibiting perivascular pseudo-rosettes with centrally hyalinized blood vessel and focal nuclear pleomorphism. Immunohistochemistry staining illustrated reactivity for glial fibrillary acidic protein and integrase interactor 1 (INI-1). These features rendered the diagnosis of astroblastoma. A comprehensive review of the current literature to summarize the clinicopathological and radiological characteristics, prognostic factors and current treatment strategies of astroblastomas is also presented. Our study would expand the pool of this uncommon tumor towards its better understanding and optimal treatment.

Distal esophageal duplication cyst with gastro-esophageal reflux disease: a rare association and a management challenge

Esophageal duplication cysts are rare congenital abnormalities of the foregut and may be associated with other conditions. Association of esophageal duplication with Gastro-Esophageal Reflux Disease [GERD] has not been reported in children. We are reporting a case of a 16 months baby who had antenatal diagnosis of diaphragmatic hernia. Postnatal CT chest, however, suggested a distal esophageal duplication cyst and a contrast esophagogram showed grade-IV GER. A thoracoscopy in another hospital excluded esophageal duplication at that time. Later, he presented with hematemesis in our department and was re-evaluated. Repeat CT confirmed a persistent 2.5 x 1.3 cm cyst in distal esophagus. Upper GI endoscopy suggested grade-II esophagitis with a wide patent gastro-esophageal junction. The child was treated with left thoracotomy, excision of the duplication cyst and thoracic fundoplication. He had an uneventful post-operative recovery and is doing well at 6 months follow-up

Estimation of time since injuries [age of wound] in living medico-legal cases of mansehra

Objective: The objective was to study the way in which duration of injury or time since injury [age of the wound] is assessed in live medico legal cases in rural area, to know and analyze the time since injury recorded inMedico Legal register and have an idea that how much time later the injured person is examined after injury or how much time later he reach to a doctor for opinion of duration of injury and otheropinion

Study Design: Retrospective study

Place and Duration of Study: This study was carried out at a medico legal centre of Mansehra District fromJanuary to August of2005

Materials and Methods: The study is a record based research, 100 cases were selected, which were consecutively recorded from the previously registered MLC cases in a center of Mansehra district. Data of time since injury or duration of injury [age of the wound] along with preliminary data was recorded from the record and analyzed

Results: In 100 cases the time since injuries were 0 to 59 minutes, 1hour to 6 hours, 7 hours to 12 hours, 13 hours to 24 hours and others. Among the victims having 25 years of age only one1 [1%] had times of injury of 0 to 59 Minuit's, of age of 26year to 45 year only 2[2%] were having time of 0 to 59 mints and no one above 45 years ofage has the same time. 35 [35%] cases of age 25 years were having time since injury of 1 to 6 hours, 33[33%] cases of age 26 to 45 years were havingsame time and only 5of above the age of 45 years had duration of injuryof 1 to 6 hours. 17[17%] of all the cases has age of injury up to 7 to 12 hours. 7 [7%] of total cases has time of 13 to 24 hour

Conclusion: Our study reflect the true situation ofsubjected societywhere the hospital is in the reach ofpopulation and this also reflect upon some influence of injured person act 2004, according to which the victim shall be taken to hospital for treatment as early as possible and the legal matter can be dealt with later on, among male victims 2[2%] and among female 1[1%] has age of wounds of 0 to 59mints mean less than one hour, 48[48%] male and 25[25%] female had age of wound of 1 to 6 hours, 1[1%] female and 6[6%] male were having time of injury of 13 to 24hours

Prostatic carcinoma; association between serum prostatic specific antigen [PSA] and gleason grade

During the past many years the availability of serum PSA as a screening marker, has encouraged its use to diagnose both prostatic cancer and its recurrence. Patients with high S/PSA are at increased risk of advanced carcinoma prostate and screening at an earlier stage would help to manage it accordingly. The aim of this study was to determine association between serum prostatic specific antigen [PSA] levels and Gleason grade in prostatic carcinoma patients. Descriptive, case series study. Department of Urology and Renal Transplantation in collaboration with Institutional laboratory of Bahawal Victoria Hospital, Bahawalpur. June 2012 to June 2014. Total 160 patients of age 50-80 years with biopsy proven prostatic carcinoma were included. Patients with h/o radiotherapy for prostatic carcinoma and anti-androgen therapy were excluded. Histological slides of each patient were reviewed by using the Gleason grading system. Gleason grade of each patient was correlated with his serum prostatic specific antigen [PSA] report which was done before surgery or biopsy. In our study, mean age was 66.89 +/- 9.28 years. Mean serum PSA was 21.41 +/- 13.67 ng/ml. Intermediate grade cancer was found in 38.75% patients followed by moderate to poorly differentiated cancer in 31.86% patients. Gleason score >/= 7 was significantly higher in patients with serum PSA >20 ng/mL than those with serum PSA

Salivary gland tumours: a tertiary care hospital experience

To study demographic, clinical and histopathological features of salivary gland tumours in a tertiary care hospital. Prospective cross sectional study. This study was carried out in the Department of ENT, Head and Neck surgery, Postgraduate Medical Institute, Lady Reading Hospital Peshawar from June 2010 to May 2014. This prospective cross sectional study of 4 years was carried out in the Department of ENT, Head and Neck surgery, Postgraduate Medical Institute, Lady Reading Hospital Peshawar. All the patients qualifying inclusion criteria were evaluated in terms of detailed history, thorough examination and relevant investigation. After performing required surgery specimen was examined for histopathology. In this study 123 patients were included with mean +/- SD age of 40 +/- 5.1 years [age range 7–76 years]. Males were 81 and females were 42 with male: female ratio of 1.9:1. Most of the patients presented in 4th decade [28.45%, 35]. Lump was the commonest clinical feature lasting for 1-5 years [66.66%, 82]. Among the tumours 77.23% were benign while 22.76% were malignant. Benign tumours were commonly noticed in parotid gland [53.65%]. Pleomorphic adenoma was the commonest benign tumour [65.04%, n-80], affecting parotid gland in 52.03%. Mucoepidermoid carcinoma is the commonest malignant tumour [12.19%] predominantly found in minor salivary gland of palate [6.50%]. Salivary gland tumours predominantly affecting middle aged male population. Benign tumours are the commonly occurring salivary gland tumours. Pleomorphic adenoma is commonly occurring benign tumour affecting predominantly parotid gland while mucoepidermoid carcinoma is the commonest malignant tumour of salivary glands

Toxicity studies on herbal formulation used in diabetes mellitus

In current study herbal formulation was prepared for Diabetes mellitus [type 2]. It consists of the extracts of Salacia reticulate, Cinnamomum zeylanicum, Lagerstroemia speciosa, Camellia sinensis and Gymnema sylvester. Toxicity studies were carried out on heart, liver, kidney and blood of both male and female rabbits. Drug was administered in a dose of 15mg/kg body weight daily for 90 days. On 91[th] day, blood was drawn from animals and investigated for changes in biochemical and hematological levels. After that animals were sacrificed and their organs [liver, heart and kidney] were analyzed for histo-pathological changes. In biochemical tests for lipid profile, significant decreased [male-70.64 +/- 0.321; female-69.80 +/- 0.365] in triglycerides level were observed, no significant change was recorded in Cholesterol HDL ratio, LDL, VLDL level. A significant increase [male-16.00 +/- 1.418; female-10.00 +/- 0.709] was observed in HDL level. In liver function test significant decrease was observed in Gamma GT [male-10.08 +/- 0.862; female-7.00 +/- 0.709]. Alkaline phosphatase [male-79 +/- 0.838; female-51.1 +/- 1.810], SGPT [male-54 +/- 0.709; female- 43.04 +/- 2.060], direct bilirubin [male-0.024 +/- 0.005; female-0.014 +/- 0.002] and total bilirubin [male-0.109 +/- 0.003; 0.106 +/- 0.049] were observed. Non-significant changes were observed in serum total protein, globulins, albumin and A/G ratio. No significant changes were noticed in urea level and serum electrolytes. In cardiac enzymes significant decrease was observed in LDH [male-443 +/- 5.61; female-360 +/- 1.848] and SGOT [male-27 +/- 0.709; female-28 +/- 1.418] level and highly significant rise in CPK [male- 3128 +/- 8.478; female-1598 +/- 7.483] and CK[-]MB [male-446 +/- 2.308; female- 438 +/- 2.819]. In hematological profile, significant decrease was observed in Hb [male-12.3 +/- 0.392; female-12.4 +/- 0.1], RBC count [male-6.60 +/- 0.167; female-5.74 +/- 0.25] and Hematocrit [HCT/PCV] % in both male and female rabbits [male- 45.70 +/- 0.255; female-43.50 +/- 0.448] and significant [p<0.5] increased in WBC count [male-8.40 +/- 0.401; female- 9.10 +/- 0.054]. Significant [p<0.5] decrease in blood glucose level and HbA1c [male-3.36 +/- 0.113; female-3.16 +/- 0.076] was observed. In histopathological studies mild edema was observed in heart and there was no change in histo-architecture of liver and kidneys. It is concluded that formulation does not showed any chronic toxicity in adult dose

Frequency of metabolic abnormalities in urinary stones patients

To determine the'frequency of metabolic abnormalities in the serum and urine of patients with urinary stones disease. Two hundred patients with either multiple or recurrent urolithiasis diagnosed on ultrasonography and intravenous urography were included in this study. 24 hour urine sample were collected from each patient and sent for PH, specific gravity, Creatinine, uric acid, calcium, phosphate, oxalate, citrate and magnesium. In addition, blood sample of each patient was also sent for serum levels of urea, creatinine, uric acid, phosphate and calcium. Mean age of patients was 38 +/- 7.75 years with male to female ratio of 2:1. The main presenting complaint was lumber pain and 82.5% patients were found to have calcium oxalate stones on chemical analysis. Metabolic abnormalities were found in 90.5% patients, whereas there were no metabolic abnormalities in 19 [9.5%] patients. Forty patients [21.5%] only had one metabolic abnormality and 157 [78.5%] patients had multiple metabolic abnormalities. Hyperoxaluria was the most commonly observed metabolic abnormality and was found in 64.5% patients. Other significant metabolic abnormalities were hypercalciuria, Hypercalcemia, hypocitraturia and hyperuricemia. This study concludes that frequency of metabolic abnormalities is very high in patients with urolithiasis and hyperoxaluria, hypercalciuria and hypocitraturia are the most important metabolic abnormalities observed in these patients

Association of hypothyroidism and hyperthyroidism with age and gender in balochistan, CENAR Quetta

Aims and Objectives: A retrospective study of all thyroid patients registered at the centre of Nuclear Medicine and Radiotherapy [CENAR], Quetta from 1st January2010 to December 2011[02years]. The aim of this study was to highlight gender and age wise distribution of hypothyroid and hyperthyroid patients in CENAR Quetta

Study design: A retrospective study

Place and Duration: A retrospective study of 2051 files of Thyroid patients was carried out in CENAR Quetta from1st January 2010 to December 2011 [02years]

Results: Out of 2051 patients, the most common gender was female with a total of 1442 [Hypothyroid female: 487; Hyperthyroid female: 231; Euthyroid female: 724] and the common age group was 16-40yr with a total of 1453[16-40yr Hypothyroid male: 153 and Female: 337; 16-40yr Hyperthyroid male: 113 and Female: 139; 16-40yr Euthyroid male: 158 and Female: 553]

Comparison between double J [DJ] ureteral stenting and percutaneous nephrostomy [PCN] in obstructive uropathy

To compare the complications rate of percutaneous nephrostomy and double J ureteral stenting in the management of obstructive uropathy. Total number of 300 patients of age 20-80 years who underwent JJ stenting or percutaneous nephrostomy for obstructive uropathy were included in this study. Patients were divided in two groups i.e. A and B. In group A, 100 patients who underwent double J ureteral stenting while in group B, 200 patients who underwent percutaneous nephrostomy tube insertion were included. The stent was inserted retrograde by using cystoscope, under mild sedation or local anesthesia. While the percutaneous nephrostomy was done under ultrasound guidance by using local anesthetic agent. Complications were noted in immediate post-operative period and on follow up. Majority of the patients were between 36 to 50 years of age with male to female ratio was 2.6:1. The most common cause of obstructive uropathy was stone disease i.e. renal, ureteric or both. Post DJ stent, complications like painful trigon irritation, septicemia, haematuria and stent encrustation were seen in 12.0%, 7.0%, 10.0% and 5.0% patients respectively. On the other hand, post-PCN septicemia, bleeding and tube dislodgment or blockage was seen in 3.5%, 4.5% and 4.5% respectively. In this study, overall success rate for double J stenting was up to 83.0% and for percutaneous nephrostomy [PCN] was 92.0% [p < 0.0001]. Percutaneous nephrostomy is a safe and better method of temporary urinary diversion than double J stenting for management of obstructive uropathy with lower incidence of complications

Pattern of causes and management of permanent loss of voice studied at a tertiary care hospital

To determine the frequency of causes of hoarseness leading to permanent loss of voice and discuss their management. This descriptive study was carried out at the department of ENT, Head and Neck Surgery, Lady Reading Hospital Peshawar from January 2009 to December 2011. All these patients were evaluated in terms of detailed history, thorough examination and relevant investigations. Biopsy from laryngeal mass was taken in case of tumours. Total laryngectomy was performed in patients with advanced laryngeal tumours provided with preoperative counseling regarding postoperative handicaps. The patients with laryngeal narrowing due to trauma were subjected to laryngeal stenting. The data was analyzed using SPSS 15. Out of 16 patients 10 were male and 6 were female with male: female ratio of 1.6:1. The ages ranged from 09-75 years with mean age of 43.68 +/- S.D 18.65 years. Majority of patients [68.75%] had low socioeconomic status. Main presentation of these patients was hoarseness [100%]. The commonest cause of change of voice was laryngeal carcinoma [n-6, 37.5%], followed by blast injury [25%].Endolaryngeal stenting was the commonest [43.75%] procedure performed for traumatic laryngeal stenosis followed by total laryngectomy. Most of the patients gained good esophageal speech. It is concluded that beside laryngeal cancer, trauma to the larynx is a common cause of permanent loss of voice resulting due to increased incidence of violence in our set up. Esophageal speech can be easily and successfully instituted in laryngectomized patients among other voice rehabilitative options

Prevalence of cancer in CENAR Quetta

Aims and Objectives: A retrospective study of allcancer registered cases at the Center for NuclearMedicine and Radiotherapy [CENAR] Quetta From1st Jan, 1998 to 31st December 2009[12 Years] wascarried out. CENAR Quetta is the only cancermanagement center in Balochistan. The aim of thisanalysis was to highlight the prevalence of Cancerin Balochistan

Study Design: A retrospectivestudy

Place and duration of Study: The study wasconducted at CENAR Quetta

Results: During thestudy period, 12022 cancer patients were registeredat CENAR and BMCH Quetta. Out of these 10924files of patients [91.19%] were analyzed. The datawere analyzed from various angles of prevalencee.g. total number of registered cancer patients, Sex,Age, Histopathology, Demographic profile etc

Conclusion: As cancer management is a globalchallenging health problem including Pakistan, sothe first step for all health program worldwide is tohighlight the prevalence, incidence and etiologicalfactors of the disease in the locality, for step wisegoing towards management and control

Reconstruction of nasal alar defect; use of nasolabial skin flap

To assess the outcome of nasolabial flap for ala plasty in patients with alar defect. Descriptive study. Department of E.N.T, Head and Neck Surgery Postgraduate Medical Institute [PGMI] Lady Reading Hospital [LRH] Peshawar. January 2006 to December 2007. In this study we included 35 patients. A detailed history and thorough physical examination regarding general condition of the patient and specifically E.N.T of the patient with emphasis on the alar soft tissue deformity, both from cosmetic and functional aspect was recorded on preformed proforma. Pre-operative and post-operative photographs were taken after taking written consent from all the patients. All procedures were carried out under local infiltrative anesthesia and were covered by intravenous prophylactic antibiotics. These patients were followed at one month, six month and one year intervals. Our study included 35 patients of nasal ala plasty with superiorly based nasolabial flap. Out of 35 patients 26 [74.29%] were males and 9 [25.71%] were female with female to male ratio of 1:2.8. Males dominated nasal deformity as males are more exposed to trauma. Average age in males was 47 years [range 24-70 years] and in females it was 48.5 years [range 27-70 years]. The patients presented with nasal alar deformity in the age range from 25 to 70 years, while 19 patients [54.28%] presented during 31 to 50 years of age. Trauma was dominated [n=28, 80%] among the causative factors for alar soft tissue loss in these 35 patients. Twenty-eight [80.00%] patients were fully satisfied both cosmetically and functionally, 04 patients [11.42%] were partially satisfied only cosmetically and 03 patients [8.57%] were not satisfied with their nasal cosmetic improvement and functional results. Nasal ala plasty with superiorly based nasolabial flap provide good cosmetic result with minimal complications

Rare foreign bodies [pellets] migrating through the gastrointestinal tract spontaneously. report of 2 cases

Foreign body ingestion or insertion in children is a common clinical condition. Foreign body may cause number of complications if not detected and treated in time. Firearm injury is not uncommon. Injury by air gun may cause pellets to retain inside human body. Here we present two cases of air gun injury where pellets entered the esophagus and passed through gastrointestinal tract spontaneously without causing any complication

Assessment of the outcome of optical internal urethrotomy

Background: Stricture urethra is a common surgical problem, especially in under developed countries

Objective: To determine the outcome of optical internal urethrotomy under local anesthesia in treatment of urethral stricture disease

Materials and methods: This descriptive study was conducted in department of Urology and Renal Transplantation, Quaid-e-Azam Medical College /Bahawal Victoria Hospital, Bahawalpur, from 1st July 2009 to 30th June 2012. Total number of 100 patients of age 16 to 75 years with diagnosis of stricture urethra of any etiology on Retrograde Urethrogram and MCUG 2cm in size or patients of stricture with neurogenic bladder, diabetes mellitis, congenital or malignant strictures were excluded from the study. Retrograde urethrogram and voiding cysto-urethrogram was done in every patient to assess stricture length and location. Then optical internal urethrotomy was performed under local anesthesia using 2% xylocain gel and 3mg inj. midazolam given intravenously for sedation. Patients were retained under observation in ward for 24 hours to assess complications like pain, bleeding and extravasation of urine. Follow up period was 6-12 months for these particular patients under study

Results: Majority of the patients [60%] were between 46 to 60 years of age. Iatrogenic injuries were the main cause [45%] followed by traumatic causes [40%]. The most common site was bulbous urethra in [59%] followed by membranous urethra [17%]. Post procedure morbidity comprised of irrigation fluid extravasations [3%], bleeding [6%] and urinary incontinence in [2%] patients. Recurrent strictures were noted in [15%] patients. In our study, initial success rate was [60%] and overall success rate was [83%]

Conclusion: Optical internal urethrotomy can safely be performed under local anesthesia as a day-care procedure and the procedure is well tolerated by the patient without any hospitalization and anesthesia risk

Clinico-pathological profile of sinonasal masses: study of 90 cases

To determine the clinicopathological profile of sinonasal masses studied at a tertiary care hospital. This descriptive study was conducted at the department ofENT, Head and Neck Surgery, Postgraduate Medical Institute Lady Reading Hospital Peshawar from Sept. 2008 to Aug. 2010, with total duration of 02 years. After admitting the patients'a detailed history was taken and thorough examination of ear, nose, throat and neck was carried out. Necessary investigations were performed. After taking an informed consent all the patients were subjected to proper surgical treatment and specimens were examined by histopathologist. All these patients were followed for minimum of six months duration on monthly basis. This study included 90 cases constituting 49 male and 41 female, with male: female ratio of 1.2:1. The age of the patients ranged from 08-65 years with mean age of 33.13 + S.D 18.67 years. The complaints of these patients were left side nasal obstruction [43.33%], Epistaxis [34.44%] and headache [27.77%]. Incisional biopsy of sinonasal masses was taken in 31 cases [34.44%] while among the surgical procedure antrochoanal polypectomy was the commonest [31.11%]. Histopathological diagnosis was obtained and simple inflammatory polyp was the commonest finding [63.3%] followed by angiofibroma [11.11%]. It is concluded that sinonasal masses mainly present with nasal obstruction, nasal discharge and benign masses predominate. Benign sinonasal masses are best treated with surgical excision

Comparison of in-out and overnight catheterization in post operative urinary retention

To determine better modality of management of post operative urinary retention comparing in-out with overnight catheterization. Randomized controlled trail. Combined Military Hospital, Lahore, tertiary care hospital from July 2007 to June 2008. Sixty patients of postoperative urinary retention were recruited in the study in strict compliance with the inclusion and exclusion criteria. Informed verbal consent was taken. Patients were randomized using random number table into two equal groups. Group A was subjected to in-out catheterization modality. Group B was subjected to overnight catheterization modality. Procedure was carried out in complete privacy. Need to recatheterize the patient was assessed and then he was recatheterized accordingly. Frequency of recatheterization was calculated for each group. Frequency of recatheterization was significantly higher in group A as compared to group B [p=0.022]. Overnight catheterization is a better method for dealing with post operative urinary retention as compared to in-out catheterization

An audit of tracheostomy at a tertiary care hospital

To determine the indications and complications of tracheostomy in a tertiary care hospital. This descriptive study was conducted at the department of ENT, Head and Neck surgery, Lady Reading Hospital Peshawar from January to December 2010. This study included 160 patients fulfilling inclusion and exclusion criteria. All these patients were properly evaluated. After taking well informed consent tracheostomy was performed in all the patients as emergency or elective procedure depending upon the clinical condition of the patient. The data was collected on a prof or ma and it was analyzed using SPSS version 10. A total of 160 patients underwent tracheostomy who constituting 110 male and 50 female, with male: female ratio of 2.2:1. The age of the patients ranged from 01-75 years with mean age of 37.61 +/- S.D 19.99 years. Tracheostomy was performed in 148 cases [92.5%] as emergency and in 12 cases [7.5%] as elective procedure. The commonest indication for tracheostomy was trauma [65.62%] followed by infection [26.25%]. Elective tracheostomy was performed for inoperable tumours. The early complications were 37.5% while late complications were 7.5%. It is concluded that the common etiology of tracheostomy in our part of the world is airway obstruction due to trauma and complications of tracheostomy can be minimized by improving the postoperative care of tracheostomized patients

diagnostic value of fine needle aspiration cytology in masses of the salivary glands

To determine the sensitivity and specificity of fine needle aspiration cytology in masses of the various salivary glands. The study included 49 cases. It was conducted at the Departments 0f ENT, Hayatabad Medical Complex, Peshawar and Saidu Teaching Hospital, Saidu Sharif, Swat from January 1, 2002 to December 31, 2009. Patients undergoing Fine Needle Aspiration Cytology followed by open biopsy were included in the study. The results obtained on FNAC were compared with those obtained on biopsy findings of the respective specimens and the specificity and sensitivity of FNAC were calculated from the data. The FNAC findings in salivary glands were; Benign 38, Malignant 7 and Suspicious 4. The biopsy findings were; Benign 33 and Malignant 16. Comparison of FNACs and biopsy in the salivary glands taken as True Negative, True positive, False Negative and False Positive respectively was; 32, 10, 6 and 1. The Sensitivity and Specificity for FNAC were calculated at 62.50% and 96.97% respectively. The results of this study show that FNA cytologic diagnoses in the salivary gland tumours are reliable and treatment can be planned on its basis. However, owing to a higher number of false negative cases occurring in this study, it is recommended that a negative cytology report should be viewed with suspicion. The diagnosis should be confirmed by open biopsy if clinical suspicion persists

Multiple carpometacarpal volar dislocation

A case of multiple Carpometacarpal joints volar dislocation in a young man of 25 years of age is reported. He presented with pain and deformity of his left hand immediately after road traffic accident. He was unable to move his left hand. X-rays of the affected hand showed volar dislocation of all four medial Carpometacarpal joints. Dislocated joints were reduced, fixed with K-wires and immobilized in slab. K-wires were removed after 8 weeks. Hand function is satisfactory on the follow-up

Angiofibroma of middle turbinate

We report a rare case of angiofibroma of middle turbinate. A man of 17 years presented to out patient department [OPD] of ENT, Head and Neck Surgery Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, Pakistan with presenting complaint of progressive obstruction of right side of nasal cavity for last 3 months. On ENT examination there was a reddish fleshy mass in the right nasal cavity. It was firm on probing, arising from the middle turbinate of lateral wall of nasal cavity and was sensitive on touching. On CT scan the mass was limited to lateral wall of right side of nasal cavity which was iso-dense with no bony erosion. The mass was removed in toto intranasally and specimen was sent for histopathology study. The histopathology report was angiofibroma. The patient is followed regularly and he is disease free so far