A rare case of P63-negative sinonasal NUT midline carcinoma in the elderly
  • Anum Qayum
    Khyber Medical College, Peshawar, Pakistan
  • Malik Waleed Zeb Khan
    Khyber Medical College, Peshawar, Pakistan
  • Abdul Rehman Arshad
    CMH Lahore Medical College, Lahore, Pakistan
  • Samar Hasnain
    Khyber Medical College, Peshawar, Pakistan
  • Muhammad Danyal Tariq
    Lady Reading Hospital, Peshawar, Pakistan
  • Salman Khan
    Department of Internal Medicine, Staten Island University Hospital/Northwell Health, Staten Island, USA
  • Shakir Ullah
    Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, USA


Cytokeratin, NUT Midline Carcinoma (NMC), Squamous Cell Carcinoma, p63, Head and Neck


A nuclear protein in testis (NUT) midline carcinoma arises from squamous cells and is often located in the head, neck, and lungs. This report focuses on the negative p63 mutation and older age at the diagnosis of a NUT carcinoma, which has significant prognostic implications. A 62-year-old patient presented initially with a three-year history of recurring frontal headaches, intermittent nasal bleeding, and a sensation of a nasal cavity mass. An incisional biopsy revealed a poorly differentiated NUT carcinoma in the left maxillary sinus. A functional endoscopic sinus surgery was performed, but the cancer recurred. As a result, a total maxillectomy was performed, and the patient was declared cancer-free with no evidence of residual disease. This is a rare instance of a p63-negative midline NUT cell carcinoma (NCC) in an elderly patient, which could potentially contribute to a more favourable prognosis and longer survival compared to other reported cases.



  • Lee T, Cho J, Baek C-H, Son Y-I, Jeong H-S, Chung MK, et al. Prevalence of NUT carcinoma in head and neck: analysis of 362 cases with literature review. Head Neck 2020;42:924–938.
  • Bishop JA, Westra WH. NUT midline carcinomas of the sinonasal tract. Am J Surg Pathol 2012;36:1216–1221.
  • Lo Muzio L, Santarelli A, Caltabiano R, Rubini C, Pieramici T, Trevisiol L, et al. p63 overexpression associates with poor prognosis in head and neck squamous cell carcinoma. Hum Pathol 2005;36:187–194.
  • McLean-Holden AC, Moore SA, Gagan J, French CA, Sher D, Truelson JM, et al. NUT carcinoma in a patient with unusually long survival and false negative FISH results. Head Neck Pathol 2021;15:698–703.
  • Numakura S, Saito K, Motoi N, Mori T, Saito Y, Yokote F, et al. P63-negative pulmonary NUT carcinoma arising in the elderly: a case report. Diagn Pathol 2020;15:134.
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    Published: 2024-01-17
    Issue: 2024: Vol 11 No 2 (view)

    How to cite:
    Qayum A, Khan MWZ, Arshad AR, Hasnain S, Tariq MD, Khan S, Ullah S. A rare case of P63-negative sinonasal NUT midline carcinoma in the elderly: Nut Midline Carcinoma. EJCRIM 2024;11 doi:10.12890/2024_004265.

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