A case of advanced NUTc of the nasal cavity: case report and review of the literature

Nuclear protein in testis carcinoma (NUTc) is a rare and highly aggressive salivary gland tumor predominantly affecting young patients. It typically involves midline head and neck structures, progresses rapidly, and is associated with a median survival of 6 to 9 months, resulting in an 80% mortality rate within the first year post-diagnosis. In this study, we present a rapidly progressing case of a 28-year-old male diagnosed with NUTc localized to the right nasal cavity (clinical stage cT4bN2M0, IVb). The patient underwent four cycles of cetuximab (anti-EGFR) combined with albumin-bound paclitaxel and cisplatin, achieving transient partial remission before experiencing rapid disease progression. During the observation period, his clinical condition deteriorated precipitously, rendering surgical intervention unfeasible and necessitating a transition to second-line chemotherapy (cisplatin + etoposide, EC regimen). Following one cycle of EC, the patient received symptomatic supportive care; however, during the two-month follow-up, he reported worsening headaches and was subsequently lost to follow-up. This case highlights the critical need for innovative diagnostic and therapeutic approaches, including prompt immunohistochemical staining and molecular testing in symptomatic patients, early tumor burden reduction, and rigorous follow-up protocols to improve survival outcomes.