Although most children have nose bleeds and occasional allergies and sinus infection, sometimes tumors of the nose and sinus present with similar symptoms. It is a good idea for a child with continuous sinus problems or nose bleeds to be evaluated by an otolaryngologist-head and neck surgeon to be sure it is not a tumor or other treatable condition.

Non-epithelial neoplasms constitute the majority of sinonasal (sinus) tumors in children and adolescents. Among these, rhabdomyosarcoma (RMS) or undifferentiated sarcoma and non-Hodgkin lymphoma, account for the majority of cases. 14% of head and neck RMS cases come from the nasal cavity and 10% from the paranasal sinuses.

Nasopharyngeal carcinoma accounts for one third of the nasopharyngeal neoplasms in children. As in adult patients, these are associated with the Epstein-Barr virus (EBV) infection (found in malignant cells). Less frequently, Ewing’s sarcoma/PNET can present in this location. These tumors have also been described as secondary malignancies following treatment of retinoblastoma and other neoplasms.

Esthesioneuroblastoma is a rare sinonasal tumor historically related to Ewing/PNET, although more recently comparative genomic hybridization analysis disputes this relation. Other less common sinonasal tumors presenting in children include hemangioma and hemagiopericitoma, fibroma and fibrosarcoma, malignant fibrous histiocytoma, and desmoid fibromatosis.