A previously healthy 4-year-old boy with Down syndrome is brought to the physician by his mother because of a foul-smelling discharge from the right nostril for the past 2 weeks. In this period, his mother has noticed the patient has had loud breathing while inhaling which was not present before. His temperature is 37°C (98.6°F), pulse is 90 beats/min, respirations are 22/min, and blood pressure is 90/60 mm Hg. Physical examination shows malodorous, grey discharge in the right nasal cavity. Endoscopic examination of the nose confirms the diagnosis.
Which of the following is the most likely diagnosis?
- A) Allergic rhinitis
- B) Foreign body
- C) Juvenile nasopharyngeal angiofibroma
- D) Nasal hematoma
- E) Nasopharyngeal carcinoma