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

  • H F Dean (a1), S Hadjisymeou (a1), G Morrison (a1) and I Hore (a1)



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.


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.


Corresponding author

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:


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



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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;22:4135–9
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;2013:816409
3Martin, H, Ehrlich, HE, Abels, JC.Juvenile nasopharyngeal angiofibroma. Ann Surg 1948;127:513–36
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;34:133–41
5Brennan, B.Nasopharyngeal carcinoma. Orphanet J Rare Dis 2006;1:23
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;17:2356–65
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;14:693–8
8Leong, JL, Fong, KW, Low, WK.Factors contributing to delayed diagnosis in nasopharyngeal carcinoma. J Laryngol Otol 1999;113:633–6
9Wei, WI, Sham, JS.Nasopharyngeal carcinoma. Lancet 2005;365:2041–54
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;118:4892–900


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

  • H F Dean (a1), S Hadjisymeou (a1), G Morrison (a1) and I Hore (a1)


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