Tracheal resection and reconstruction under non-intubated anesthesia for nuclear protein in testis carcinoma: a case report

Sep 23, 2026

Nuclear protein in testis (NUT) carcinoma is an extremely rare, highly aggressive solid tumor with no established treatment consensus and generally poor survival outcomes. This report documents a 42-year-old man with tracheal malignant NUT carcinoma treated with tracheal resection and reconstruction under non-intubated anesthesia, followed by adjuvant platinum-based chemotherapy. FDG PET imaging showed uptake in the upper tracheal wall, and diagnosis was confirmed by immunohistochemical staining. No complications or recurrence occurred during 12-month follow-up.

LanguageEnglish

CategoryHealthcare

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Abstract

Background

Case presentation

Conclusions

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Li etal. World Journal of Surgical Oncology (2025) 23:188 [https://doi.org/10.1186/s12957-025-03824-z](https://doi.org/10.1186/s12957-025-03824-z) World Journal of Surgical Oncology CASE REPORT Open Access Tracheal resection and reconstruction under non-intubated anesthesia for nuclear protein in testis carcinoma: a case report Zijian Li 1†, Chudong Wang 1†, Yuxuan Li2, Rui Wang 1, Yun Juan Liang 1 and Shuben Li 1* Abstract Background Nuclear protein in testis (NUT) carcinoma is a rare and highly aggressive solid tumor with a poor overall survival outcome. There’s no recognized treatment or consensus on the management for NUT carcinoma. To date, few cases of tracheal NUT carcinomas have been reported, and the prognosis of these cases was dismal. We report a rare case of tracheal resection and reconstruction performed under non-intubated anesthesia for tracheal NUT carcinoma with good outcomes, aiming to contribute our experience in the surgical treatment of tracheal NUT carcinoma. Case presentation A 42-year-old male with a 20-packyear smoking history presented to the hospital with dyspnea and cough and was diagnosed with a tracheal malignant carcinoma. Fluorodeoxyglucose positron emission tomography showed FDG accumulation in the upper tracheal wall. The patient underwent tracheal resection and reconstruction under non-intubated anesthesia, with the final diagnosis of NUT carcinoma confirmed via immunohistochemical staining. The patient then received adjuvant platinum-based chemotherapy postoperatively. Neither complication nor cancerous recurrence was observed during the 12-month follow-up. Conclusions Surgery remains the preferred choice for early tracheal malignant tumors, including rare tumors like NUT carcinoma. This case report provides valuable insights into the imaging characteristics, pathological diagnosis, and treatment approach for tracheal NUT carcinoma. Future studies should aim to expand the case series to enhance our understanding and management of this aggressive neoplasm. Keywords NUT carcinoma, Tracheal tumor, Tracheal resection and reconstruction, Non-intubated anesthesia †Zijian Li and Chudong Wang contributed equally to this work. *Correspondence: Shuben Li [13500030280@163.com](13500030280@163.com) 1Department of Thoracic Surgery, Guangzhou Medical University 1st Affiliated Hospital, Guangzhou, China 2Department of Pathology, Guangzhou Medical University 1st Affiliated Hospital, Guangzhou, China Background Nuclear protein in testis (NUT) carcinoma is an extremely uncommon malignant and rapidly progressive solid neoplasm that is characterized by the rearrangement of the NUTM1 gene. This lethal tumor exhibits a higher prevalence in the adolescent and young adult demographic. Head, neck, and mediastinum are the commonly affected regions, with tracheal NUT carcinoma being a rare finding [1]. So far, recognized therapeutic guidelines for NUT carcinoma are yet to be established, and the reported median survival time was 6.7 months, with a 19% overall survival(OS) rate at 2 years [2]. To © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obta

FAQs

Why is treatment for NUT carcinoma challenging?

NUT carcinoma is rare and highly aggressive, and there is no recognized treatment or management consensus established so far. Reported outcomes have generally been poor.

How was the tracheal NUT carcinoma diagnosis confirmed?

The patient’s final diagnosis of NUT carcinoma was confirmed via immunohistochemical staining after undergoing tracheal resection and reconstruction.

What were the postoperative outcomes during follow-up?

During the 12-month follow-up, neither complications nor cancerous recurrence were observed after surgery and adjuvant platinum-based chemotherapy.

Sep 23, 2026

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