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Epistaxis

Epistaxis

Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...

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A Nose Bleed Reveals Rhabdomyosarcoma's Seed.

Vijendra S Shenoy¹, Ananya Sinha¹, Saksham Dhawan¹

¹Dept of ENT and Head & neck surgery, Kasturba Medical College, Mangalore Manipal Academy of Higher Education, Manipal, India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India

|November 19, 2024

Summary

A rare case of embryonal rhabdomyosarcoma, a soft tissue tumor in children, presented as epistaxis in a 5-year-old boy. Diagnosis of the botryoid type was confirmed via biopsy and IHC markers.

Keywords:

Embryonal rhabdomyosarcom Nasopharynx Parapharyngeal space

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Area of Science:

Pediatric Oncology
Soft Tissue Pathology

Background:

Embryonal rhabdomyosarcoma is the most common pediatric soft tissue tumor.
Head and neck locations represent 40% of cases, with nasopharyngeal RMS being aggressive.
Nasopharyngeal RMS (parameningeal) has a propensity for CNS involvement and poor prognosis.

Purpose of the Study:

To report a rare case of embryonal rhabdomyosarcoma in a pediatric patient.
To highlight diagnostic challenges and imaging findings of nasopharyngeal RMS.

Main Methods:

Clinical presentation of epistaxis in a 5-year-old boy.
Diagnostic workup included oral examination and MRI of the neck.
Biopsy and immunohistochemical (IHC) markers confirmed the diagnosis.

Main Results:

MRI revealed a hyperintense lesion in the nasopharynx encasing the internal carotid artery.
Diagnosis of embryonal rhabdomyosarcoma, botryoid type, was established.
The tumor extended into the parapharyngeal region and carotid space.

Conclusions:

Embryonal rhabdomyosarcoma can present insidiously with symptoms like epistaxis.
Multimodality imaging and IHC are crucial for diagnosing rare pediatric head and neck tumors.
Botryoid type RMS requires prompt diagnosis and management due to its aggressive nature.