Abstract
Epistaxis is considered to be a most important symptom in head and neck cancer. Twenty patients with nasal malignancy and 76 benign cases visited our tumor clinic of Tokyo University Hospital during the period of November 1972 to October 1977. Nine cancer patients (45%) and 41 benign cases (54%) complained of epistaxis. As benign cases included eight patients whose only symptom was epistaxis and seven who revealed an angioma or angiofibroma, epistaxis was more frequent in benign than in cancer ones. The chief complaint in 30% of both groups (six cancer and 23 benign) was epistaxis.
As for malignancy of paranasal sinuses, we observed 144 patients with cancer and 200 benign cases during the same period. In fifty-nine cancer patients (41%) and 48 cases of a benign occurrence (24%) complained of epistaxis. Twenty (14%) and ten (5%) had epistaxis as chief complaint, respectively.
There were 76 patients with nasopharyngeal cancer and 61 benign cases during the period. Twenty-one (28%) and nine (15%) complained of severe epistaxis, and six (8%) and six (10%) had the symptom as the chief complaint. Benign cases included four with angioma or angiofibroma.
In total, 187 patients had epistaxis and 89 of them (48%) revealed nasal, paranasal or nasopharyngeal malignancy. The chief complaint of 71 cases was epistaxis and 32 (45%) had cancer.
During the same five years, 478 patients visited our emergency clinic because of epistaxis and 74 required institutional treatment. Head and/or neck cancer was not demonstrated in any of these patients.
Epistaxis due to head and neck cancer is not massive, but is continuous. Patients with epistaxis should always be examined carefully even if the bleeding is not severe.
