Qayum Anum, Khan Malik Waleed Zeb, Arshad Abdul Rehman, Hasnain Samar, Tariq Muhammad Danyal, Khan Salman, Ullah Shakir
Khyber Medical College, Peshawar, Pakistan.
CMH Lahore Medical College, Lahore, Pakistan.
Eur J Case Rep Intern Med. 2024 Jan 17;11(2):004265. doi: 10.12890/2024_004265. eCollection 2024.
A nuclear protein in testis (NUT) midline carcinoma arises from squamous cells and is often located in the head, neck, and lungs. This report focuses on the negative p63 mutation and older age at the diagnosis of a NUT carcinoma, which has significant prognostic implications. A 62-year-old patient presented initially with a three-year history of recurring frontal headaches, intermittent nasal bleeding, and a sensation of a nasal cavity mass. An incisional biopsy revealed a poorly differentiated NUT carcinoma in the left maxillary sinus. A functional endoscopic sinus surgery was performed, but the cancer recurred. As a result, a total maxillectomy was performed, and the patient was declared cancer-free with no evidence of residual disease. This is a rare instance of a p63-negative midline NUT cell carcinoma (NCC) in an elderly patient, which could potentially contribute to a more favourable prognosis and longer survival compared to other reported cases.
Molecular analysis of a NUT carcinoma and age at diagnosis may serve as a potential means for predicting patient prognosis in cases of midline NCC.Each patient should receive careful monitoring and a personalised treatment strategy based on their molecular studies. Surgical resection, along with a combination of radiotherapy and chemotherapy, has the potential to improve overall survival rates.In line with the commonly observed relationship between increased p63 mutation and poorer survival rates, a negative p63 expression in squamous cell carcinomas may indicate a more favorable prognosis. This hypothesis highlights the importance of further research to validate these findings.
睾丸核蛋白（NUT）中线癌起源于鳞状细胞，常发生于头、颈和肺部。本报告聚焦于NUT癌诊断时的p63阴性突变和患者高龄，这具有重要的预后意义。一名62岁患者最初有三年反复出现的额部头痛、间歇性鼻出血及鼻腔肿物感病史。切开活检显示左上颌窦有低分化NUT癌。进行了功能性鼻内镜鼻窦手术，但癌症复发。因此，实施了全上颌骨切除术，患者被宣布无癌，无残留疾病证据。这是老年患者中罕见的p63阴性中线NUT细胞癌（NCC）病例，与其他报告病例相比，可能预示着更有利的预后和更长的生存期。
NUT癌的分子分析和诊断时的年龄可能是预测中线NCC患者预后的潜在手段。每位患者应根据其分子研究接受仔细监测和个性化治疗策略。手术切除联合放疗和化疗有可能提高总生存率。与p63突变增加和生存率降低之间常见的关系一致，鳞状细胞癌中p63表达阴性可能预示更有利的预后。这一假设凸显了进一步研究以验证这些发现的重要性。
