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Juvenile angiofibroma is a benign tumor, well known for aggressive extracranial growth, that frequently spreads to involve the skull base and intracranial compartment as well. The meninges, however, provide a strong barrier against intracerebral spread. This article reports an unusual case of angiofibroma with dural penetration, cavernous sinus involvement, and adherence to the temporal lobe of the brain. Controversy exists as to how the intracranial extensions are best managed. Our experience with this case, combined with review of the literature, suggests that these lesions can be removed surgically, eliminating in most cases the need for radiation therapy.