NUT Midline Carcinoma of the Nasal Cavity

Abstract

Nuclear protein in testis (NUT) midline carcinoma (NMC) is a rare, aggressive, poorly differentiated form of squamous cell carcinoma caused by a chromosomal rearrangement of the NUT gene on chromosome 15. These tumors have a predilection for midline and paramidline structures of the upper aerodigestive tract and mediastinum and can affect patients across a broad age range, including children. In the current example, a 53 year old male presented with a mass originating in the left nasal cavity. The clinical, radiographic, and morphologic features of NMC are discussed.

Keywords: NUT midline carcinoma; Nasal; Nasal cavity; Nuclear protein of testis; Radiology; Sinonasal; Undifferentiated carcinoma.

Fig. 1

a Coronal CT (bone window) reveals an expansile near midline nasal cavity mass with osseous remodeling and opacification of the left maxillary sinus, b on the coronal T-1 weighted MR images the heterogeneously enhancing mass appears circumscribed and does not extend into the maxillary sinus

Fig. 2

Sagittal T-1 MR imaging demonstrates a large nasal cavity mass with internal variegation. There is a degree of circumscription and extension of the tumor posteriorly into the nasopharynx

Fig. 3

There is extensive sinonasal involvement by sheets and nest of basaloid tumor cells. Tumor necrosis and lymphovascular invasion were present

Fig. 4

a The tumor was composed of relatively uniform basaloid cells with basophilic nucleoli and occasional foci of abrupt keratinization, b positive nuclear NUT immunostaining is present