title: Recurrent epistaxis in a nine-year-old boy: benign or malignant?
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Paediatric Otorhinolaryngology, Evelina London Children's Hospital,Guy's and St Thomas' NHS Foundation Trust,UK.
authors: H F
authors: HF
authors: Dean
authors: Department of Paediatric Otorhinolaryngology, Evelina London Children's Hospital,Guy's and St Thomas' NHS Foundation Trust,UK.
authors: S
authors: S
authors: Hadjisymeou
authors: Department of Paediatric Otorhinolaryngology, Evelina London Children's Hospital,Guy's and St Thomas' NHS Foundation Trust,UK.
authors: G
authors: G
authors: Morrison
authors: Department of Paediatric Otorhinolaryngology, Evelina London Children's Hospital,Guy's and St Thomas' NHS Foundation Trust,UK.
authors: I
authors: I
authors: Hore
mesh_terms: D002277:Carcinoma; D002648:Child; D003937:Diagnosis, Differential; D004844:Epistaxis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000503:physiopathology; D009305:Nasopharynx / Q000473:pathology*; D011859:Radiography; D012008:Recurrence
keywords: Endoscopy