Radiologic features of NUT midline carcinoma in an adolescent

Abstract

We present a case of NUT midline carcinoma (NMC) mimicking lymphoma in an adolescent boy, with attention to multidetector CT appearance and pattern of metastasis on [F-18]2-fluoro-2-deoxyglucose positron emission tomography (FDG PET/CT). Few case reports have focused on the imaging characteristics of this rare tumor in the pediatric imaging literature. A newly described but increasingly recognized disease entity, NMC should enter the differential of pediatric midline tumors displaying particularly aggressive characteristics on imaging.

Demystifying NUT Midline Carcinoma: Radiologic and Pathologic Correlations of an Aggressive Malignancy

“…CT features of heterogeneous enhancement of the primary tumor and low attenuation of involved lymph nodes correlate with pathologic evidence of hemorrhage and necrosis (secondary to rapid tumor growth unsupported by the blood supply) on patients' pathologic specimens after surgical resection in NUT midline carcinoma [26,27]. The radiographic findings in our institutional series are largely in agreement with the previously reported findings throughout the literature.…”

“…The radiographic findings in our institutional series are largely in agreement with the previously reported findings throughout the literature. In contrast, however, we did not find evidence of tumoral calcification in any of the primary or metastatic sites of disease and only rarely noted tumor hemorrhage [18,26].…”

“…The tumor usually shows necrosis [18,25] and occasionally tumoral calcification [18] and has a propensity to invade adjacent structures, including the heart, pericardium, esophagus, central airways, and vessels within the mediastinum [18,20,22]. Given the aggressive nature of the tumor and its proclivity to invade vascular structures and the central airways, contrastenhanced CT of the chest is useful to evaluate these critical structures and provide guidance for urgent debulking surgery if deemed necessary [26] (Fig. 2).…”

NUT carcinoma of the thorax: Case report and review of the literature

“…Comprehensive summary of relevant clinicopathological data of thoracic NC published in the literature[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Pulmonary and Extrathymic Mediastinal Tumors

“…On MRI, the mass exhibits decreased signal intensity on T1-weighted images, mildly increased signal intensity on T2-weighted images, and heterogeneous contrast enhancement. Both the primary tumor and metastases are FDG-avid on PET (Rosenbaum et al 2012). The lungs are the most common site of metastases and metastases to the liver, kidney, brain, spinal cord, and subcutaneous soft tissues have also been reported (Polsani et al 2012).…”