Sinonasal NUT carcinoma mimicking acute ethmoiditis

Area of Science:

• Oncology
• Pathology
• Neurology

Background:

• Nuclear protein in testis (NUT) carcinoma is a rare, aggressive malignancy.
• It typically affects young adults, often in the head and neck, thorax, or midline structures.
• Diagnosis can be challenging due to non-specific presenting features.

Purpose of the Study:

• To report a case of sinonasal NUT carcinoma presenting with neurological symptoms.
• To highlight the diagnostic challenges and emphasize the need for increased awareness.
• To underscore the importance of multidisciplinary management for this rare cancer.

Main Methods:

• A case study of a young woman with non-specific neurological symptoms.
• Diagnostic workup included blood tests, imaging (CT/MRI), and immunohistochemistry.
• Treatment involved radical surgical resection followed by chemotherapy and radiotherapy.

Main Results:

• Imaging revealed an ethmoid mass with orbital and intracranial extension, mimicking severe ethmoiditis.
• Biopsy confirmed NUT carcinoma.
• The patient achieved no evidence of disease 11 months post-treatment.

Conclusions:

• Sinonasal NUT carcinoma diagnosis is often delayed due to non-specific clinical, radiological, and histopathological features.
• Limited awareness among healthcare professionals contributes to diagnostic delays.
• Multidisciplinary management and increased awareness are critical for improving prognosis.