Abstract
BackgroundHead and neck cancer during pregnancy is uncommon. Specifically, laryngeal cancer in pregnancy has only been previously reported 10 times. HPV p16+ supraglottic cancer during pregnancy has never been described in the literature prior to this case report. This case is important to report to understand the most effective and safe diagnostic, treatment and follow-up options available for pregnant patients with laryngeal cancer.Case presentationThis report describes a case of a 33-year-old patient who was 24 weeks pregnant presenting with dysphonia and odynophagia. After laryngeal biopsy and MRI she was diagnosed with T3N1M0, stage three p16+ squamous cell carcinoma of the supraglottis. After inter-disciplinary consultation as well as extensive patient discussion, an awake tracheostomy, PEG tube placement and then elective C-section at 28 weeks’ gestation was completed. This was followed by chemoradiotherapy. The patient has remained free from disease with a healthy child at four years post-treatment.ConclusionSupraglottic cancer during pregnancy is rare with only four previous cases reported in the literature. This case report elucidates the importance of including multiple specialities as well as patient preference in the decision-making process regarding treatment for patients with supraglottic cancer during pregnancy. Furthermore, diagnostic and treatment guidelines for pregnant patients with head and neck cancers should be established to promote the best possible oncological, obstetrical and neonatal care.
Highlights
Supraglottic squamous cell carcinoma accounts for approximately one third of all laryngeal cancers [1]
This case report elucidates the importance of including multiple specialities as well as patient preference in the decision-making process regarding treatment for patients with supraglottic cancer during pregnancy
Ten cases of laryngeal cancer during pregnancy exist in the literature [13,14,15,16,17,18,19,20,21,22], with one published case report on supraglottic squamous cell carcinoma during pregnancy [14]
Summary
Head and neck cancer’s during pregnancy do occur. In the case of supraglottic cancer in pregnancy, the mother’s airway and oncological outcomes as well as the fetus’ viability for life are of the utmost priority. Once the neonate is delivered, the patient may be able to undergo oncologic treatment for their cancer. There are no guidelines or consensus regarding the treatment of head and neck cancer’s during pregnancy. Head and neck cancers in this population reveal a unique challenge whereby oncologic, obstetric and anesthetic concerns must be considered. We urge for the collaborative creation of a treatment pathway for pregnant patients with head and neck cancers. With a unified understanding of treatment of head and neck cancer in this population, pregnant patients may be able to receive better oncological, obstetrical and neonatal care
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Schedule a callMore From: Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
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