CASE REPORT article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Toripalimab-based chemoimmunotherapy for unresectable sinonasal NUT carcinoma of the maxillary sinus: a case report
Provisionally accepted
- 1Department of Otorhinolaryngology, Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, China
- 2Department of Pathology, Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, China
- 3Department of Medical Laboratory, Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, China
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Background: Nuclear protein in testis (NUT) carcinoma is an extremely rare and highly aggressive epithelial malignancy driven by NUTM1 rearrangements. Sinonasal involvement is uncommon and often presents with non-specific clinical and radiologic features, leading to delayed diagnosis. Optimal management remains undefined, and outcomes are poor when complete resection is not feasible. Case presentation: A 31-year-old man developed progressive numbness and swelling of the left cheek after tooth extraction. Imaging revealed a soft-tissue mass involving the left maxillary sinus with adjacent maxillofacial soft-tissue extension. Endoscopic biopsy demonstrated a poorly differentiated carcinoma with diffuse punctate nuclear NUT expression, high proliferative index (Ki-67 ~50%), and PD-L1 expression in both tumor cells and immune cells. ^18F-FDG PET-CT showed no regional or distant metastases. Given unresectability, the patient received toripalimab (240 mg) combined with docetaxel and cisplatin every 3 weeks. MRI after three cycles showed early radiologic improvement, and further tumor regression was observed after six cycles, consistent with a partial response. The patient subsequently continued on toripalimab-based maintenance therapy with ongoing stable residual disease at the latest follow-up (approximately 5 months after therapy initiation and 6 months from diagnosis). Conclusion: To our knowledge, this is the first reported case of toripalimab-based chemoimmunotherapy demonstrating an early partial response and short-term disease control in unresectable maxillary sinus NUT carcinoma. It supports the potential role of PD-1 blockade integrated with platinum–taxane chemotherapy as a component of multimodal management for sinonasal NUT carcinomas.
Keywords: case report, chemoimmunotherapy, NUT carcinoma, PD-1 inhibitor, Toripalimab
Received: 08 Dec 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 Lin, Yu, Tan, Wang, Xie, Huang and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhiyong Huang
Bei Guo
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