iMedPub Journals www.imedpub.com 2019 Vol. 5 No.2:79 Case Report 1 © Under License of Creative Commons Attribution 3.0 License | This article is available in: http://gynecology-obstetrics.imedpub.com/ Gynaecology & Obstetrics Case report ISSN 2471-8165 Philippe PA*, Elly B, Cheruiyot A, Shurie S and Orang'o OE Department of Reproductve Health, Moi University School of Medicine, Eldoret, Kenya *Corresponding author: Philippe PA  philippe_poli@yahoo.fr Department of Reproductve Health, Moi University School of Medicine, Eldoret, Kenya. Tel: +254 (0) 706 224 646 Citaton: Philippe PA, Elly B, Cheruiyot A, Shurie S, Orang'o OE (2019) Nasopharyngeal Carcinoma in Pregnancy: Management Approach Case Report at Moi Teaching and Referral Hospital, Eldoret-Kenya. Vol. 5 No.2:79 Introducton Nasopharyngeal carcinoma (NPC) is a rare tumour with challenging antepartum management in resource-limited setngs. Because of its rarity in most countries (<1 per 100,000 per year), most of obstetricians in developing countries are unfamiliar with NPC, its clinical presentaton, and its management during pregnancy. In additon, the diagnosis of cancer in general and partcularly NPC in sub-Saharan Africa is challenging due to several factors such as, scarce of facilites providing diagnosis and treatment of cancers [1] lack of public awareness of the disease and poor health literacy, socio-cultural disadvantage, and predominantly low socio-economic status of most people translates to poverty reducing access to health care. To date, a number of researches have shown that malignant tumours can be managed successfully during pregnancy with use of a multdisciplinary approach to maximize the maternal and perinatal outcomes [2]. This case study emphasises the mult-disciplinary management approach of nasopharyngeal carcinoma in pregnancy, as well as challenges related to its diagnosis in resource-limited setngs. Case Report A 26-year-old Gravida 7 Para 6 was admited at 28 weeks gestaton by ultrasound as a referral from a remote peripheral facility for further management of right lateral neck mass, persistent headache, epistaxis, nasal obstructon and hematemesis complicated with severe anaemia. She developed these symptoms 3 months prior to frst contact with a primary clinician. Her previous medical history was unremarkable. She had 6 successful homebirths. This was her frst admission. Her father was undergoing treatment for advanced stage NPC. Her psychosocial history was signifcant by poor quality of family and social support correlated with her low educaton level. However, her past psychiatric history and mental status was unremarkable. Episodes of epistaxis and pain were frequently managed with Tranexamic acid, Tramadol and sometmes with antbiotcs at a remote peripheral health facility with improvement of symptoms. On physical examinaton, she was sick looking and afebrile, blood pressure (BP) 110/66 mmHg. There were bilateral neck masses, the right measured 6 × 4 cm and the lef 3 × 3 cm. Macroscopically, these represented a posterior nasopharynx mass covered by the sof palate, bleeding in response to touch. The gravid abdomen’s fundal height measured 26 cm. She was pale without jaundice. There were no palpable contracton, vaginal bleeding or discharge, and the cervix appeared closed on pelvic examinaton. Received: August 02, 2019; Accepted: August 14, 2019; Published: August 21, 2019 Nasopharyngeal Carcinoma in Pregnancy: Management Approach Case Report at Moi Teaching and Referral Hospital, Eldoret-Kenya Abstract Nasopharyngeal carcinoma is an uncommon tumour, which raises management dilemma in pregnant women. The condition has a considerable effect on the pregnancy outcome, considering the risk of preterm delivery. This paper reports a case of 26 years old Gravida 7 Para 6 admitted at 28 weeks of gestation with epistaxis, hematemesis and a neck mass. The head CT scan showed a right paranasal space soft tissue mass with bony destruction and bilateral cervical adenopathy, consistent with neoplastic carcinoma. Histopathological examination confrmed the diagnosis of nasopharyngeal carcinoma. Deterioration of the patient’s condition, necessitated emergency caesarean delivery at 32 weeks to accommodate further management. Keywords: Nasopharyngeal carcinoma; Pregnancy; Chemo-radiation