Sinonasal NUT carcinoma: A case report and literature review

Abstract

Sinonasal NUT carcinoma (NC) is an exceptionally rare and fatal form of cancer, and the literature on this pathology is scarce. In this article, we report a case of ethmoidal NUT carcinoma, initially locally advanced then metastatic. Our case is the first to test immunotherapy and anti-EGFR in metastatic sinonasal NUT carcinoma.This is a 47-year-old man diagnosed with ethmoidal NUT carcinoma cT4N0M0. Neoadjuvant chemotherapy (CT) was started with 5 cycles of TCF (Docetaxel 40 mg/m2 CDDP 40mg/m2 and 5FU 2000mg/m2), resulting in a discrete partial metabolic response, followed by radiotherapy (RT) (total dose, 70 Gy; 2 Gy × 35 Fractions). The PET scan re-evaluated at 2 months showed no tumor response and metastatic bone progression. In view of the epidermoid component of the histology, treatment with Nivolumab was introduced, but failed after 6 cycles, followed by Carboplatin (AUC 2), Paclitaxel (80mg/m2) 3 weeks out of 4 and Cetuximab (500mg/m2) twice monthly, but failed after 3 cycles, and finally Vinorebline (30mg) 3 times weekly, stopped early due to deterioration in general condition. The patient died 17 months after initial diagnosis.

Keywords

• Sinonasal
• NUT carcinoma
• Immunotherapy
• Cetuximab