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

Area of Science:

• Otolaryngology
• Pediatric Oncology

Background:

• Epistaxis is a common pediatric symptom, but unilateral, persistent cases warrant thorough investigation.
• Nasopharyngeal masses are rare in children, making diagnosis challenging.

Observation:

• A nine-year-old boy presented with a six-month history of intermittent unilateral epistaxis.
• Radiological and endoscopic investigations revealed a highly malignant nasopharyngeal carcinoma.
• The patient experienced a significant hemorrhage requiring surgical intervention.

Findings:

• Nasopharyngeal carcinoma is an uncommon etiology of epistaxis in pediatric patients.
• The malignancy demonstrated rapid growth and presented with severe hemorrhage.

Implications:

• This case underscores the importance of early flexible nasendoscopy in evaluating pediatric epistaxis.
• Prompt diagnosis and management are critical for improving outcomes in rare pediatric nasopharyngeal malignancies.