A 15 year aged boy presents with unilateral nasal blockade,mass in the cheek and epistaxis, the likely diagnosis is ?

Recurrent epistaxis, nasal obstruction and swelling over cheek in a 15 years boy suggest the diagnosis of nasopharyngeal angiofibroma. Juvenile nasopharyngeal angiofibroma (JNA) is a benign, but locally aggresive, tumor of nasopharynx seen in prepubeal and adolescent males. It is the most common benign neoplasm of nasopharynx. It is a highly vascular tumor and blood supply of the tumor most commonly arises from the internal maxillary aery. Juvenile nasopharyngeal angiofibroma (JNA) occurs almost exclusively in males. Female with Juvenile nasopharyngeal angiofibroma (JNA) should undergo genetic testing. Onset is most commonly in the second decades, the range is 7-19 years. The exact cause is unknown. As the tumour is predominantly seen in adolescent males in the second decade of life, it is thought to be testosterone dependent. Such patients have a hamaomatous nidus of vascular tissue in the nasopharynx and this is activated to form angiofibroma when male sex hormone appears.