Pregnancy and malignant neoplasms of the head and neck

This paper, based on a literature review, deals with the occasional development of a head and neck neoplasm in the pregnant woman. This rare event makes for some challenging problems in patient management, insofar as the otolaryngologist is actually responsible for taking care of 2 patients - the mother and her unborn child. In particular, 4 tumor types have figured prominently among those head and neck tumors arising in pregnant women: cancer of the larynx, cancer of the thyroid, malignant melanomas, and malignant lymphomas of the head and neck. Of these, the most common appear to be melanomas, followed by lymphomas, thyroid carcinomas, and, finally, laryngeal carcinomas. The thyroid tumors, lymphomas, and laryngeal carcinomas do not appear to behave more aggressively in pregnant than in nonpregnant patients; there is, however, some anecdotal evidence to suggest that melanomas in pregnant women may be more aggressive neoplasms than similar-stage tumors in nonpregnant women. One difficulty in treating any of these tumor types in this clinical setting is the limitation that may be imposed on the use of adjuvant therapy by the presence of the unborn child, which may put the attending physicians in the difficult position of balancing less aggressive therapy for the mother against the potential for harming the baby through use of toxic systemic therapy.