Biopsies from 25 juvenile nasopharyngeal angiofibromas (JNAs) and respective normal inferior turbinates were examined and compared, The expression patterns of the messenger RNAs (mRNAs) for various growth factors possibly involved in the growth of mesenchymal cells, as well as angiogenesis and fibrosis, were also compared. These growth factors included insulin-like growth factor II (IGF-II), basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), transforming growth factors-beta(1) (TGF-beta(1)) and platelet-derived growth factors (PDGF-A and PDGF-B), Quantification of mRNA coding for proto oncogenes and suppressor genes related to proliferation (i.e., c-myc, c-fos, p53) was also undertaken. Tumor and turbinates expressed similar levels of bFCF; VEGF, TGF-beta(1), c-myc, c-fos, and PDGF-A mRNAs. The presence of TGF-beta(1) protein was confirmed by immunohistochemistry in several structures that characterize the lesions of JNA, which suggests that TGF-beta(1) may play a role in the development of the fibrous component of this tumor, PDGF-B and p53 were overexpressed (i.e., twice the mean level found in turbinates) in 50% and 32% of JNAs, respectively, but there was no statistical significance when compared with controls. Statistically significant increased expression of IGF-II mRNA was observed in JNA (P=.04). IGF-II mRNA levels were correlated to p53 (P=.05) and PDGF-B (P=.034), indicating a possible synergistic action of such factors in JNA The results of this study suggest that IGF-II might be a potential growth regulator of nasopharyngeal angiofibromas.