If<unk>  is suspected based on physical examination (a smooth vascular submucosal mass in the posterior nasal cavity of an adolescent male), imaging studies such as CT or MRI should be performed. Biopsy should be avoided as to avoid extensive bleeding since the tumor is composed of blood vessels without a muscular coat. Antral sign or Holman-Miller sign (forward bowing of posterior wall of maxilla) is pathognomic of<unk> . DSA (digital subtraction angiography) of carotid artery to see the extension of tumors and feeding vessels Differential diagnosis * Antro-choanal polyp (benign non neoplastic growth) * Rhinosporidiosis (as bleeding point is here too) * Malignancy—nasopharyngeal carcinoma, lymphoma, plasmacytoma, rhabdomyosarcoma * Chordoma * Nasopharyngeal cyst * Pyogenic granuloma
Nasopharyngeal angiofibroma
Laryngeal cyst
Nasopharyngeal cyst
Laryngeal papillomatosis
Laryngocele
Thyroglossal cyst
Parapharyngeal abscess
Nasal glioma