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Recurrent epistaxis in a nine-year-old boy: benign or malignant?

Published online by Cambridge University Press:  23 March 2015

H F Dean ,
S Hadjisymeou ,
G Morrison  and
I Hore
H F Dean*
Affiliation:
Department of Paediatric Otorhinolaryngology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, UK
S Hadjisymeou
Affiliation:
Department of Paediatric Otorhinolaryngology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, UK
G Morrison
Affiliation:
Department of Paediatric Otorhinolaryngology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, UK
I Hore
Affiliation:
Department of Paediatric Otorhinolaryngology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, UK
*
Address for correspondence: Dr H Dean, c/o Veronica Callendar, 6th Floor, Evelina London Children's Hospital, Westminster Bridge Road, London SE17 1EH, UK E-mail: harrydean@doctors.org.uk
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Abstract

Objective:

We present the case of a rare cause of epistaxis in a paediatric patient, together with the diagnostic and management challenges associated with this condition.

Case report:

A previously well nine-year-old boy presented with a six-month history of intermittent unilateral epistaxis. Radiological investigation and endoscopic biopsy confirmed a highly malignant nasopharyngeal mass consistent with carcinoma. The tumour continued to grow rapidly. Whilst awaiting intervention, the patient experienced a further significant haemorrhage requiring surgical intervention.

Conclusion:

Nasopharyngeal carcinoma is a rare cause of epistaxis amongst children in the UK. Early flexible nasendoscopy can help delineate both benign and sinister causes of symptoms in this region.

Keywords

NasopharynxCarcinomaPediatricsEpistaxisEndoscopy
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 3 , March 2015 , pp. 293 - 295
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Oral presentation at the 146th Semon Club meeting, 5 November 2013, London, UK

References

1French, CA, Kutok, JL, Faquin, WC, Toretsky, JA, Antonescu, CR, Griffin, CA et al. Midline carcinoma of children and young adults with NUT rearrangement. J Clin Oncol 2004;22:4135–9Google Scholar
2Duarte, VM, Liu, YF, Shapiro, NL.Uncommon presentation of a benign nasopharyngeal mass in an adolescent: comprehensive review of nasopharyngeal masses. Case Rep Pediatr 2013;2013:816409Google Scholar
3Martin, H, Ehrlich, HE, Abels, JC.Juvenile nasopharyngeal angiofibroma. Ann Surg 1948;127:513–36Google Scholar
4Yi, Z, Fang, Z, Lin, G, Lin, C, Xiao, W, Li, Z et al. Nasopharyngeal angiofibroma: a concise classification system and appropriate treatment options. Am J Otolaryngol 2013;34:133–41CrossRefGoogle ScholarPubMed
5Brennan, B.Nasopharyngeal carcinoma. Orphanet J Rare Dis 2006;1:23Google Scholar
6Bray, F, Haugen, M, Moger, TA, Tretli, S, Aalen, OO, Grotmol, T.Age-incidence curves of nasopharyngeal carcinoma worldwide: bimodality in low-risk populations and aetiologic implications. Cancer Epidemiol Biomarkers Prev 2008;17:2356–65Google Scholar
7Pathmanathan, R, Prasad, U, Sadler, R, Flynn, K, Raab-Traub, N.Clonal proliferations of cells infected with Epstein-Barr virus in preinvasive lesions related to nasopharyngeal carcinoma. N Engl J Med 1995;14:693–8Google Scholar
8Leong, JL, Fong, KW, Low, WK.Factors contributing to delayed diagnosis in nasopharyngeal carcinoma. J Laryngol Otol 1999;113:633–6Google Scholar
9Wei, WI, Sham, JS.Nasopharyngeal carcinoma. Lancet 2005;365:2041–54Google Scholar
10Buehrlen, M, Zwaan, CM, Granzen, B, Lassay, L, Deutz, P, Vorwek, P et al. Multimodal treatment, including interferon beta, of nasopharyngeal carcinoma in children and young adults: preliminary results from the prospective, multicenter study NPC-2003-GPOH/DCOG. Cancer 2012;118:4892–900CrossRefGoogle Scholar