NUTS IN THE LUNGS: AN UNFORTUNATE RIME

TYPE: Abstract Publication TOPIC: Lung Cancer PURPOSE: Nuclear Protein in Testis (NUT) Carcinoma is an extremely rare and undifferentiated malignancy characterized by the rearrangement of NUT gene. Typically affects midline structures in younger individuals. We report a case of a NUT Carcinoma of the Lung. METHODS: A 51-year-old female non-smoker with no significant past medical history was presented to a hospital with fatigue and left anterior pleuritic chest pain for 2-weeks. She was performed a chest radiography which showed a homogeneous opacification with concave upper margin in left lower hemithorax, suggestive of pleural effusion. Computed Tomography (CT) scan confirmed a massive pleural effusion associated with pleural thickening. Diagnostic thoracentesis was performed and was suggestive of exudative effusion with no detection of malignant cells. Blind pleural biopsy showed tumoral cells with high proliferation rate (Ki67 50%). Following surgical pleural biopsy and immunohistochemical analysis identified a NUT Carcinoma. 18F-Fluorodeoxyglucose Positron Emission Tomography scan for staging confirmed a left pleural thickening (SUV: 11.7), revealing also bilateral mediastinal ganglion, left adrenal and multiple lithic bone metastasis. RESULTS: The patient was proposed to clinical trial but died 1 month after the diagnostic, due to rapid progression of the disease, invading left main bronchus, vascular structures and pericardium with large pericardial effusion. CONCLUSIONS: NUT carcinoma is a highly aggressive disease that can also affect non-middle structures. CLINICAL IMPLICATIONS: Due to its rarity and lack of experience it can be un/misdiagnosed. NUT Carcinoma should be included in differential diagnosis of rapid progressive malignancy in children and young adults. DISCLOSURE: No significant relationships. KEYWORD: NUT Carcinoma