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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*
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

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.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

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

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