DEK::AFF2 fusion positive carcinoma, a potentially misdiagnosed entity: overview of histology and diagnostic clues

Abstract

We report a case of an 88-year-old male with a large nasal lesion thought to be an inverted papilloma clinically and on imaging, but subsequently diagnosed histologically as a carcinoma, specifically, a non-keratinizing squamous cell carcinoma with the distinct DEK - AFF2 fusion. This variant of carcinoma in the head and neck is an emerging entity thought to have a distinct morphology, that should prompt molecular studies. Overlapping histological features with benign papillomatous lesions emphasizes the need for identification of this entity, as they have been associated with an aggressive clinical course including relapse and distant metastases. In addition, identification of the specific fusion may potentially add to the therapeutic armamentarium.