{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:40Z","timestamp":1787017060906,"version":"build-2736575974"},"reference-count":19,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,1,9]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    NUT(Nuclear Protein in Testes) carcinoma is a rare and aggressive malignancy characterised by rearrangements of the\n                    <jats:italic>NUTM1<\/jats:italic>\n                    gene, primarily affecting midline structures in children and adults. We report a middle childhood male who presented with a left cheek swelling initially noticed 2 months earlier, surgically resected 1 month ago and recurred over the past week. Histopathology revealed a poorly differentiated neoplasm, with immunohistochemistry showing diffuse CK5\/6, P63, P40 expression, intact SMARCA4, P16 negativity and speckled NUT nuclear staining confirming NUT carcinoma. Imaging demonstrated local extension with small-volume nodal metastases. He was treated with nine cycles of VDC-IE(vincristine, doxorubicin, and cyclophosphamide alternating with ifosfamide and etoposide) chemotherapy given at 3-week intervals, complicated by transient iron deficiency anaemia, followed by surgical excision with neck dissection and fibular flap reconstruction. Post-treatment positron emission tomography scan showed no metabolically active disease. Maintenance therapy with the histone deacetylase inhibitor vorinostat was initiated. This case highlights the importance of early recognition, multimodal therapy and emerging targeted treatment in improving outcomes for NUT carcinoma.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-269655","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T12:45:22Z","timestamp":1769517922000},"page":"e269655","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["NUT carcinoma of the cheek managed with chemotherapy and surgical resection"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2471-833X","authenticated-orcid":false,"given":"Raafey","family":"Imran","sequence":"first","affiliation":[{"name":"SCM, Shifa International Hospitals Ltd, Islamabad, Pakistan"},{"name":"Internal Medicine, Shifa International Hospital, Islamabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghulam","family":"Baha-Ul-Haq","sequence":"additional","affiliation":[{"name":"SCM, Shifa International Hospitals Ltd, Islamabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Danial","family":"Tarar","sequence":"additional","affiliation":[{"name":"SCM, Shifa International Hospitals Ltd, Islamabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishfaq","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Pediatric Oncology, Shifa International Hospitals Ltd, Islamabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabia","family":"Tariq","sequence":"additional","affiliation":[{"name":"Hematology and Oncology, Shifa International Hospitals Ltd, Islamabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"2026012704451444000_19.1.e269655.1","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/s12105-021-01400-x","article-title":"NUT Carcinoma of the Submandibular Gland: A Case at This Uncommon Site with Review of the Literature","volume":"16","author":"Moreno","year":"2022","journal-title":"Head Neck Pathol"},{"key":"2026012704451444000_19.1.e269655.2","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2021.700781","article-title":"Case Report and Literature Review: Primary Pulmonary NUT-Midline Carcinoma","volume":"11","author":"Zhang","year":"2021","journal-title":"Front Oncol"},{"key":"2026012704451444000_19.1.e269655.3","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-016-0763-0"},{"key":"2026012704451444000_19.1.e269655.4","doi-asserted-by":"crossref","unstructured":"Chin M , Yokoyama R , Sumi M , et al . Multimodal treatment including standard chemotherapy with vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide for the Ewing sarcoma family of tumors in Japan: Results of the Japan Ewing Sarcoma Study 04, :e28194. 10.1002\/pbc.28194 Available: https:\/\/doi.org\/10.1002\/pbc.28194","DOI":"10.1002\/pbc.28194"},{"key":"2026012704451444000_19.1.e269655.5","doi-asserted-by":"crossref","first-page":"e707","DOI":"10.1097\/MPH.0000000000001865","article-title":"NUT Carcinoma Without Upfront Surgical Resection: A Case Report","volume":"43","author":"Leeman","year":"2021","journal-title":"J Pediatr Hematol Oncol"},{"key":"2026012704451444000_19.1.e269655.6","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1007\/s12105-020-01254-9","article-title":"NUT Carcinoma Arising from the Parotid Gland: A Case Report and Review of the Literature","volume":"15","author":"Saik","year":"2021","journal-title":"Head Neck Pathol"},{"key":"2026012704451444000_19.1.e269655.7","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1093\/oncolo\/oyad177","article-title":"Prolonged Survival of NUT Midline Carcinoma and Current Approaches to Treatment","volume":"28","author":"Kaplan","year":"2023","journal-title":"Oncologist"},{"key":"2026012704451444000_19.1.e269655.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.cancergencyto.2010.06.007"},{"key":"2026012704451444000_19.1.e269655.9","doi-asserted-by":"publisher","DOI":"10.1111\/pin.12727"},{"key":"2026012704451444000_19.1.e269655.10","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/S1470-2045(23)00019-0","article-title":"Response-adapted omission of radiotherapy in children and adolescents with early-stage classical Hodgkin lymphoma and an adequate response to vincristine, etoposide, prednisone, and doxorubicin (EuroNet-PHL-C1): a titration study","volume":"24","author":"Mauz-K\u00f6rholz","year":"2023","journal-title":"Lancet Oncol"},{"key":"2026012704451444000_19.1.e269655.11","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2022.914031","article-title":"NUT Carcinoma-An Underdiagnosed Malignancy","volume":"12","author":"Lauer","year":"2022","journal-title":"Front Oncol"},{"key":"2026012704451444000_19.1.e269655.12","first-page":"304","article-title":"BRD4-NUT fusion oncogene: a novel mechanism in aggressive carcinoma","volume":"63","author":"French","year":"2003","journal-title":"Cancer Res"},{"key":"2026012704451444000_19.1.e269655.13","doi-asserted-by":"publisher","DOI":"10.1038\/sj.onc.1210852"},{"key":"2026012704451444000_19.1.e269655.14","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318198d666"},{"key":"2026012704451444000_19.1.e269655.15","doi-asserted-by":"crossref","first-page":"3956","DOI":"10.1158\/0008-5472.CAN-23-1475","article-title":"EZH2 Cooperates with BRD4-NUT to Drive NUT Carcinoma Growth by Silencing Key Tumor Suppressor Genes","volume":"83","author":"Huang","year":"2023","journal-title":"Cancer Res"},{"key":"2026012704451444000_19.1.e269655.16","first-page":"18","article-title":"NUT carcinoma: A report of 3 cases highlighting diagnostic challenges","volume":"40","author":"Stevens","year":"2019","journal-title":"Ann Diagn Pathol"},{"key":"2026012704451444000_19.1.e269655.17","doi-asserted-by":"crossref","DOI":"10.1093\/jncics\/pkz094","article-title":"An Anatomical Site and Genetic-Based Prognostic Model for Patients With Nuclear Protein in Testis (NUT) Midline Carcinoma: Analysis of 124 Patients","volume":"4","author":"Chau","year":"2020","journal-title":"JNCI Cancer Spectr"},{"key":"2026012704451444000_19.1.e269655.18","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30242"},{"key":"2026012704451444000_19.1.e269655.19","doi-asserted-by":"publisher","DOI":"10.1158\/1541-7786.MCR-21-0259"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269655","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T12:45:24Z","timestamp":1769517924000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269655"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,27]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bcr-2025-269655"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269655","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}