Primary Pulmonary NUT Carcinoma: Case Illustration and Updated Review of Literature

Abstract

•NUT carcinoma of the lung is a rare and aggressive malignancy with a median survival of 4.1 months on a previous case series. Its pathophysiology involves a NUT-BRD4 fusion mutation in approximately 75% of cases. •Even with advances in molecular characterization and development of novel therapeutic options, prognosis remains poor. Our patient progressed to diffusely metastatic disease, acute hypoxemic respiratory failure, and death within 4.7 months of the diagnosis despite chemotherapy, immunotherapy, and radiotherapy. •This case highlights the importance of testing for NUT rearrangements in all poorly differentiated lung cancers, particularly in young never-smokers, and expanding research efforts on this malignancy. •NUT carcinoma of the lung is a rare and aggressive malignancy with a median survival of 4.1 months on a previous case series. Its pathophysiology involves a NUT-BRD4 fusion mutation in approximately 75% of cases. •Even with advances in molecular characterization and development of novel therapeutic options, prognosis remains poor. Our patient progressed to diffusely metastatic disease, acute hypoxemic respiratory failure, and death within 4.7 months of the diagnosis despite chemotherapy, immunotherapy, and radiotherapy. •This case highlights the importance of testing for NUT rearrangements in all poorly differentiated lung cancers, particularly in young never-smokers, and expanding research efforts on this malignancy.