Nuclear protein in testis (NUT) carcinoma in the public sector of the Free State province, South Africa

Abstract

Background: Nuclear protein in testis (NUT) carcinoma (NC) is a rare tumour easily mistaken for a number of other tumours if a NUT immunohistochemical stain is not performed, and there is no high index of suspicion. This tumour is exceptionally aggressive, with only isolated survivors. Early identification and aggressive treatment are required. No research on NC has been conducted in South Africa and only one case has been reported from the rest of Africa. The incidence of this tumour in South Africa is, therefore, unknown.

Aim: The aim of this study was to determine the incidence of NC over a 12-year period and describe the demographic features of any patients identified.

Setting: Department of Anatomical Pathology, University of the Free State and National Health Laboratory Service (NHLS) in Bloemfontein, South Africa.

Methods: In this retrospective study, all undifferentiated malignant tumours and tumours with evidence of squamous differentiation from the head, neck and thorax seen between 01 January 2005 and 31 December 2016 were included. Nuclear protein in testis immunohistochemical staining was performed on all specimens. The stain was regarded as positive if speckled nuclear staining was observed in more than 50% of the tumour cells.

Results: In total, 498 cases were investigated, of which 424 (85.1%) belonged to male patients. The mean age of the patients was 58.6 years. Only one positive case, a 30-year-old woman with a lung mass and lymph node metastases, was identified.

Conclusion: Our findings confirmed the rarity of NC. Additional research in other provinces and the private sector is recommended to provide a comprehensive patient profile of NC in South Africa.