PREGNANCY AND MALIGNANT NEOPLASMS OF THE HEAD AND NECK

This paper, based on a literature review, deals with the occasional de velopment of a head and neck neoplasm in the pregnant woman. This rare event makes for some challenging problems in patient management, inso far 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 arisin g in pregnant women: cancer of the larynx, cancer of the thyroid, mali gnant melanomas, and malignant lymphomas of the head and neck. Of thes e, the most common appear to be melanomas, followed by lymphomas, thyr oid carcinomas, and, finally, laryngeal carcinomas. The thyroid tumors , lymphomas, and laryngeal carcinomas do not appear to behave more agg ressively in pregnant than in nonpregnant patients; there is, however, some anecdotal evidence to suggest that melanomas in pregnant women m ay be more aggressive neoplasms than similar-stage tumors in nonpregna nt 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 a djuvant therapy by the presence of the unborn child, which may put the attending physicians in the difficult position of balancing less aggr essive therapy for the mother against the potential for harming the ba by through use of toxic systemic therapy.