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Vol.62 No.3 contents

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- Case Report -

A Young Male Patient with Nuclear Protein in Testis Carcinoma of the Thorax

Kosuke Suzuki¹, Akihiko Kitami¹, Jun Ohara², Shinichi Ohashi¹, Yoko Tanaka¹, Naoya Himuro³, Shugo Uematsu¹, Mitsutaka Kadokura¹, Tetsuo Nemoto², Yukichi Tanaka^4
1Respiratory Disease Center, ²Department of Clinical Pathology, Showa University Northern Yokohama Hospital, Japan, ³Division of Chest Surgery, Department of Surgery, Showa University Hospital, Japan, ⁴Clinical Research Institute, Kanagawa Children's Medical Center, Japan

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Background. Nuclear protein in testis (NUT) carcinoma is an aggressive malignant tumor associated with chromosomal rearrangement of the NUT midline carcinoma family member 1 (NUTM1) gene. Reports of NUT carcinoma have been increasing in recent years. Case. A 26-year-old man presented to our hospital for the evaluation of bloody sputum and chest pain. Radiological imaging revealed an anterior mediastinal tumor. A computed tomography-guided needle biopsy detected thymic squamous cell carcinoma. The patient was administered four cycles of carboplatin/paclitaxel chemotherapy. Although the primary lesion responded to chemotherapy, the mediastinal lymph node showed continuous rapid growth, resulting in left recurrent nerve paralysis. Radiotherapy was initiated at the mediastinal lymph node. However, the patient subsequently developed pleural dissemination as well as liver and retroperitoneal metastasis and died seven months after his first visit. An autopsy evaluation revealed bilateral lung, liver, lymph node (lung hilum, mediastinal, and celiac), pleural, diaphragm, and retroperitoneal cancer. A histopathological evaluation of the tumor tissues showed mixed features of keratinized and undifferentiated cell components; an immunohistochemistry revealed that both components had immunopositivity for NUT and p63. The patient was ultimately diagnosed with NUT carcinoma. Conclusion. NUT carcinoma was diagnosed in this case following an autopsy. Some young patients diagnosed with thoracic squamous carcinoma may have NUT carcinoma.
key words: NUT carcinoma, NUT midline carcinoma, Thymic squamous cell carcinoma, Mediastinal tumor, Autopsy

Received: December 28, 2021
Accepted: February 25, 2022

JJLC 62 (3): 227-234, 2022