A Prompt Diagnosis and Treatment of a Case of Nuclear Protein of the Testis Carcinoma Characterized by a Bronchial Lesion and High Serum Alpha-fetoprotein Level Following Genomic Testing

Intern Med. 2024 Oct 1;63(19):2655-2660. doi: 10.2169/internalmedicine.2938-23. Epub 2024 Feb 26.

Abstract

Nuclear protein of the testis carcinoma (NUTC) is a rare and aggressive malignancy. We herein report a case of NUTC in the lung characterized by a bronchial lesion and elevated alpha-fetoprotein levels. A 35-year-old Japanese man presented to our institution with suspected advanced lung cancer based on a histological examination. Subsequently, next-generation sequencing (NGS) yielded a positive BRD4-NUTM1 fusion. In addition, positive NUT immunostaining of the lung biopsy specimen confirmed NUTC in the lungs. Systemic chemotherapy and radiotherapy showed a temporary response, with decreased serum alpha-fetoprotein levels. We highlight this case of a prompt diagnosis by NGS of NUTC in a young individual with a rapidly progressing tumor.

Keywords: BRD4-NUTM1; NUT carcinoma; alpha-fetoprotein (AFP); immune checkpoint inhibitor; lung cancer.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Lung Neoplasms* / blood
  • Lung Neoplasms* / diagnosis
  • Lung Neoplasms* / genetics
  • Male
  • Neoplasm Proteins / blood
  • Neoplasm Proteins / genetics
  • Nuclear Proteins* / genetics
  • Oncogene Proteins, Fusion / genetics
  • alpha-Fetoproteins* / analysis

Substances

  • alpha-Fetoproteins
  • Nuclear Proteins
  • NUTM1 protein, human
  • Neoplasm Proteins
  • Oncogene Proteins, Fusion
  • BRD4-NUT fusion oncogene protein, human