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Background  Poorly differentiated midline carcinoma with a translocation between chromosomes 15 and 19, i.e. t(15;19), has been recognized as a distinct clinical entity for over a decade. This tumor affects young individuals, shows a rapidly fatal clinical course despite intensive therapy. The t(15;19) results in the fusion oncogene  BRD4-NUT . Information concerning treatment of this rare disorder is scarce.    Case presentation  A 30-year-old woman was admitted with a rapidly progressing tumor in the mediastinum, cervical lymph nodes, vertebral column and the epidural space. Pathological, cytogenetic, FISH and PCR analysis revealed a glycogenated carcinoma rarely expressing cytokeratins and showing t(15;19) and  BRD4-NUT  gene rearrangement. The patient was initially treated with a Ewing sarcoma chemotherapy regimen, but had rapid progression after two cycles. She then received docetaxel and radiotherapy, which resulted in almost complete disappearance of the tumor.    Conclusion  Docetaxel may be considered for initial chemotherapy in young patients presenting with a midline carcinoma with bone marrow involvement and cytogenetic and molecular genetic finding of a t(15;19)/ BRD4-NUT- rearrangement. We herein describe, in detail, the laboratory methods by which the  BRD4-NUT  -rearrangement can be detected.

Midline carcinoma with t(15;19) and BRD4-NUTfusion oncogene in a 30-year-old female with response to docetaxel and radiotherapy