Carcinoma nut da linha media: massa cervical de crescimento fulminante

Introduction: The NUT carcinoma (CNM) is a rare carcinoma of squamous origin, genetically defined by rearrangements in the NUT gene (# 15q). It is an aggressive and invariably fatal tumor, involving the midline structures. It arises mainly in the head and neck region and mediastinum. Case report: Female patient, 45 years, was referred to the emergency room complaining of solid-food dysphagia, for a week. The physical exam showed a 7 cm diameter hard latero-cervical mass and a non pulsatile bulging on the hypopharynx, with extension to the retrocricoid region. Cervical CT revealed a large cervical mass (7.5 x 6 x 4.5 cm), heterogeneous, with irregular morphology, poorly defined limits, with a retropharyngeal median component, infiltrating the left lobe of the thyroid gland. PET-scan revealed pulmonary metastases. Biopsy of the lesion revealed the diagnosis of CNM. Due to worsening of the dysphagia, associated with high dyspnea, due to a rapid tumor growth, the patient was submitted to tracheotomy and percutaneous gastrostomy. The indicated treatment by the Oncology team was Carbo / Taxol chemotherapy and palliative RT, which the patient kept for 9 months, the time of her death due to the disease’s locoregional and pleuropulmonary progression. Conclusions: CNM is a rare entity with a low incidence, although it is possibly underestimated by the difficulty in distinguishing it through traditional anatomopathological examination of neoplasms with a low degree of differentiation or undifferentiated by the lack of access to a specific molecular study.