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Sinonasal NUT-Midline Carcinoma - A Multimodality Approach to Diagnosis, Staging and Post-Surgical Restaging.

Authors
  • Shaikh, Faiq1
  • Pagedar, Nitin2
  • Awan, Omer3
  • McNeely, Parren4
  • 1 Imaging Informatics, University of Pittsburgh Medical Center ; Molecular Imaging Physician, S&L Readings, LLC. ; CEO, Crunchtimr Medical Solutions, LLC.
  • 2 Otolaryngology - Head and Neck Surgery, University of Iowa Hospitals & Clinics, Iowa City, IA.
  • 3 Department of Radiology, Dartmouth Hitchcock Medical Center.
  • 4 Department of Radiology, University of Iowa Hospitals & Clinics, Iowa City, IA.
Type
Published Article
Journal
Cureus
Publisher
Cureus, Inc.
Publication Date
Jul 01, 2015
Volume
7
Issue
7
Identifiers
DOI: 10.7759/cureus.288
PMID: 26244120
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Nuclear protein testis (NUT) midline carcinoma is a rare malignancy involving predominantly the midline structures of the body. It is characterized by its genotypic feature of BRD4-NUT translocation, which is in contrast with other malignant processes that are usually categorized based on their histologic/phenotypic features. As these tumors may vary in their histologic presentation, they can be misdiagnosed as poorly differentiated carcinomas. Moreover, they are often very aggressive and associated with high mortality. Therefore, it is extremely important to diagnose them early using computed tomography (CT) and magnetic resonance imaging (MRI) and perform staging and restaging using 18-fluorodeoxyglucose positron emission tomography/computed tomography (18-FDG PET/CT), in addition to accurately identifying them at a microscopic and molecular level. We report a unique case of a sinonasal NUT midline carcinoma that was diagnosed with CT, staged with PET/CT, and restaged using PET/CT and MRI.

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