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

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.