{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:56:02Z","timestamp":1790934962371,"version":"4.1.0"},"reference-count":25,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003399","name":"Shanghai Science and Technology Committee","doi-asserted-by":"publisher","award":["24SF1904700"],"award-info":[{"award-number":["24SF1904700"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008750","name":"Shanghai Shen Kang Hospital Development Center","doi-asserted-by":"publisher","award":["SHDC12018118"],"award-info":[{"award-number":["SHDC12018118"]}],"id":[{"id":"10.13039\/501100008750","id-type":"DOI","asserted-by":"publisher"}]},{"award":["SHDC12018118"],"award-info":[{"award-number":["SHDC12018118"]}],"id":[{"id":"https:\/\/ror.org\/02zrtve16","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["23YF1404600"],"award-info":[{"award-number":["23YF1404600"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"award":["23YF1404600"],"award-info":[{"award-number":["23YF1404600"]}],"id":[{"id":"https:\/\/ror.org\/03kt66j61","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Nasopharyngeal angiofibroma (NA) is generally benign, but recurrent disease and rare malignant transformation remain clinically relevant beyond adolescence. We examined adult clinical presentations, records of malignant transformation, and age-related differences in stage distribution. Methods: We retrospectively reviewed 289 surgically treated patients from January 2006 through June 2026. Radkowski stage distributions were compared between patients aged &gt; 30 and \u226430 years using exact tests. Detailed clinical records were reviewed for 16 adults, and whole-genome sequencing (WGS) annotation summaries were examined for one tumor\u2013blood pair. Results: Twenty-five patients (8.7%) were older than 30 years; stage was available for 287 patients. In the detailed adult subgroup, a prior pathology-slide record described focal malignant transformation with a Ki-67 index of approximately 50% in one recurrent tumor. Two other patients had database transformation entries without accompanying pathological documentation. Four recurrences and three deaths were recorded, all in stage IIIB disease. Three men had colorectal or rectal cancer histories. Low-, intermediate-, and advanced-stage tumors accounted for 36.0%, 36.0%, and 28.0% of adult cases, compared with 17.6%, 57.3%, and 25.2% of younger cases (p = 0.0493). The genomic annotations showed a C&gt;A-predominant substitution spectrum. Conclusions: Adult NA included recurrent stage IIIB disease and a documented record of focal malignant transformation. Stage distributions differed between age groups. These clinical observations support pathological reassessment of recurrent tumors. The single-case genomic findings remain descriptive annotations.<\/jats:p>","DOI":"10.3390\/cancers18193180","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:10:48Z","timestamp":1790932248000},"page":"3180","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nasopharyngeal Angiofibroma in Adults: Age-Stratified Stage Distribution, Clinical Outcomes, and Exploratory Tumor\u2013Normal Genomics"],"prefix":"10.3390","volume":"18","author":[{"given":"Haoyuan","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huankang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanpeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8207-3657","authenticated-orcid":false,"given":"Shixing","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaole","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dehui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9139-6327","authenticated-orcid":false,"given":"Zhuofu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1001\/archotol.1996.01890140012004","article-title":"Angiofibroma. Changes in staging and treatment","volume":"122","author":"Radkowski","year":"1996","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s12105-026-01925-z","article-title":"Malignant transformation of a radiation-naive sinonasal tract angiofibroma: Clinicopathologic and molecular characterization of an exceptionally delayed transformation","volume":"20","author":"Hamada","year":"2026","journal-title":"Head Neck Pathol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Liu, X., Hu, J., Gan, W., Liu, F., and Zhong, B. (2026). Molecular mechanisms of juvenile nasopharyngeal angiofibroma: A narrative review. Curr. Oncol., 33.","DOI":"10.3390\/curroncol33030147"},{"key":"ref_4","first-page":"405","article-title":"Juvenile nasopharyngeal angiofibroma: Nationwide study on incidence, diagnosis, treatment, and recurrence","volume":"64","author":"Eriksen","year":"2026","journal-title":"Rhinology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/s40463-023-00687-w","article-title":"Early-onset juvenile nasopharyngeal angiofibroma (JNA): A systematic review","volume":"52","author":"Newman","year":"2023","journal-title":"J. Otolaryngol. Head Neck Surg."},{"key":"ref_6","first-page":"e49127","article-title":"Nasopharyngeal angiofibroma in an adult male: A case report and review of the literature","volume":"15","author":"Choi","year":"2023","journal-title":"Cureus"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Zalite, S., Cudare, K., Verzemnieks, K., Pavlovi\u010ds, S., Kup\u010ds, K., Vilks, I., Tone, T., Briede, I., and Balodis, A. (2026). Juvenile nasopharyngeal angiofibroma in an adult patient: A rare presentation with Fahr syndrome and multiple comorbidities-a case report and literature review. Diagnostics, 16.","DOI":"10.3390\/diagnostics16091327"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"rjag293","DOI":"10.1093\/jscr\/rjag293","article-title":"Adult-onset juvenile nasopharyngeal angiofibroma with delayed adult recurrence managed by revision endoscopic resection and external carotid branch ligation","volume":"2026","author":"Pachwa","year":"2026","journal-title":"J. Surg. Case Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1007\/s13353-023-00780-w","article-title":"FGFR3 and FGFR4 overexpression in juvenile nasopharyngeal angiofibroma: Impact of smoking history and implications for personalized management","volume":"64","author":"Safhi","year":"2023","journal-title":"J. Appl. Genet."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e23265","DOI":"10.1002\/gcc.23265","article-title":"Comprehensive analysis of juvenile nasopharyngeal angiofibromas via whole-exome sequencing","volume":"63","author":"Kumari","year":"2024","journal-title":"Genes Chromosom. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1016\/S0002-9440(10)64054-0","article-title":"Frequent beta-catenin mutations in juvenile nasopharyngeal angiofibromas","volume":"158","author":"Abraham","year":"2001","journal-title":"Am. J. Pathol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1016\/0016-5085(93)90164-8","article-title":"Nasopharyngeal angiofibroma in patients with familial adenomatous polyposis","volume":"105","author":"Giardiello","year":"1993","journal-title":"Gastroenterology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1111\/jon.13116","article-title":"MRI features of sinonasal tract angiofibroma\/juvenile nasopharyngeal angiofibroma: Case series and systematic review","volume":"33","author":"Baba","year":"2023","journal-title":"J. Neuroimaging"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1002\/hed.27244","article-title":"Innovative Fudan rT staging in endoscopic surgery for recurrent nasopharyngeal carcinoma","volume":"45","author":"Li","year":"2023","journal-title":"Head Neck"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1177\/01945998211011076","article-title":"Endoscopic nasopharyngectomy combined with internal carotid artery pretreatment for recurrent nasopharyngeal carcinoma","volume":"166","author":"Wang","year":"2022","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1002\/ohn.303","article-title":"Preoperative embolization techniques in the treatment of juvenile nasopharyngeal angiofibroma: A systematic review","volume":"169","author":"Kothari","year":"2023","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1002\/lary.30616","article-title":"Embolization in juvenile nasopharyngeal angiofibroma surgery: A systematic review and meta-analysis","volume":"133","author":"Diaz","year":"2023","journal-title":"Laryngoscope"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1001\/archoto.2010.83","article-title":"A new endoscopic staging system for angiofibromas","volume":"136","author":"Snyderman","year":"2010","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4130","DOI":"10.1002\/lary.70634","article-title":"The natural history of residual and recurrent disease in advanced juvenile nasopharyngeal angiofibroma: A systematic review","volume":"136","author":"Kumar","year":"2026","journal-title":"Laryngoscope"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3611","DOI":"10.1007\/s00405-025-09476-9","article-title":"Recurrent angiofibroma: Analysis of risk factors and common sites of recurrence","volume":"282","author":"Attya","year":"2025","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.anl.2024.09.004","article-title":"Endoscopic surgical management of juvenile nasopharyngeal angiofibroma: Correlating tumour characteristics, risk of hemorrhage, and recurrence","volume":"51","year":"2024","journal-title":"Auris Nasus Larynx"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1007\/s00405-023-07824-1","article-title":"Endoscopic, endoscopic-assisted and open approaches in the treatment of juvenile angiofibroma: What has been new in the past decade (and 1586 cases)?","volume":"280","author":"Jurlina","year":"2023","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1038\/ajg.2014.435","article-title":"ACG clinical guideline: Genetic testing and management of hereditary gastrointestinal cancer syndromes","volume":"110","author":"Syngal","year":"2015","journal-title":"Am. J. Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1007\/s12070-023-04331-x","article-title":"Role of CD34-immunopositive microvascular density in juvenile nasopharyngeal angiofibroma","volume":"76","author":"Jaiswal","year":"2024","journal-title":"Indian J. Otolaryngol. Head Neck Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s12070-024-05171-z","article-title":"Nasopharyngeal angiofibroma: Karyotyping profile and Florescent In-Situ Hybridization analysis with C-myelocytomatosis, tumor suppressor p53 and CEP-X\/Y probes","volume":"77","author":"Patel","year":"2025","journal-title":"Indian J. Otolaryngol. Head Neck Surg."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/19\/3180\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:14:41Z","timestamp":1790932481000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/19\/3180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,2]]},"references-count":25,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["cancers18193180"],"URL":"https:\/\/doi.org\/10.3390\/cancers18193180","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,2]]}}}