An 11-year-old boy presents to the physician's office with difficulty breathing through his right nostril for several months and a 3-week history of recurrent severe nosebleeds on the same side. The patient denies any recent trauma. His parents have given him nasal decongestants and allergy medication with no relief. There is no personal or family history of serious illness. His temperature is 37°C (98.6°F), pulse is 90 beats/min, respirations are 20/min, and blood pressure is 110/80 mm Hg. Physical examination of the nose shows septal deviation to the left and a pink, lobulated mass in the right nasal cavity that is actively bleeding. The remainder of the examination shows no abnormalities.
Which of the following is the most likely diagnosis?
- A) Arteriovenous malformation
- B) Foreign body
- C) Juvenile nasopharyngeal angiofibroma
- D) Nasal hematoma
- E) Nasal steroid overuse