PT  - JOURNAL ARTICLE
AU  - Alison Liu
AU  - Sean Fang
AU  - Karan Kapoor
AU  - Humera Babar-Craig
TI  - Haemorrhagic nasal polyp mimicking melanoma in an 83-year-old on rivaroxaban
AID  - 10.1136/bcr-2020-236309
DP  - 2020 Nov 01
TA  - BMJ Case Reports
PG  - e236309
VI  - 13
IP  - 11
4099  - http://casereports.bmj.com/content/13/11/e236309.short
4100  - http://casereports.bmj.com/content/13/11/e236309.full
SO  - BMJ Case Reports2020 Nov 01; 13
AB  - An 83-year-old woman presented with rapid onset unilateral nasal obstruction after sneezing. She had a history of hypertension and atrial fibrillation, and was on rivaroxaban. Examination revealed a dark red polypoidal lesion completely obstructing the left nostril. She underwent CT and MRI, and proceeded to urgent excision biopsy of the lesion. Intraoperative appearance was in keeping with a haemorrhagic polyp arising from the nasal septum. Histology revealed haematoma within a layer of nasal mucosa. There was no evidence of haemangioma underlying the polyp. Our literature search has identified this case as the first described haemorrhagic polyp of the nasal septum. It is likely that rivaroxaban contributed to the formation of this haemorrhagic polyp, and it is important to differentiate benign haemorrhagic lesions from malignant conditions such as melanoma. Similar cases may become more common in the future as the proportion of the population on anticoagulants increases.