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The advent of next-generation sequencing (NGS) has greatly enhanced the identification of morphologically and/or phenotypically unusual neoplasms. We report an undifferentiated carcinoma with a DEK::AFF2 fusion in a 13-year-old female from the head and neck region. DEK::AFF2 rearranged non-keratinizing squamous cell carcinoma (NKSCC) has been recognized as a distinct entity in the WHO classification of head and neck tumors, typically affecting adults. The case presented is unusual for both the patient's age and the undifferentiated morphology, which includes neuroendocrine immunophenotypic features, such as focal synaptophysin staining, dot-like cytokeratin expression, and only scattered cells positive for p63 and p40. Additional cases are needed to determine whether these features define a distinct subset of DEK::AFF2 rearranged neoplasms and to assess their potential correlation with a younger age of occurrence.
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http://dx.doi.org/10.1007/s00428-025-04071-z | DOI Listing |
Mod Pathol
October 2021
Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
A novel DEK-AFF2 fusion has been recently identified in four cases of basaloid to nonkeratinizing squamous cell carcinoma (SCC) in the sinonasal tract and middle ear with high-grade morphology. The exceptional response to immune checkpoint inhibitor in the first reported case highlights the potential clinical importance of identifying tumors with DEK-AFF2 fusions. We herein reported the first series of seven cases of DEK-AFF2 fusion-associated sinonasal SCC with deceptively bland morphology, including four cases of low-grade papillary Schneiderian carcinoma, which is a recently described tumor type with unknown molecular underpinnings.
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December 2021
Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX.
A novel DEK-AFF2 fusion was recently reported in 4 nonkeratinizing squamous cell carcinomas of the sinonasal region and skull base, including 1 with exceptional response to immunotherapy, but it is not yet clear if this rearrangement defines a unique clinicopathologic category or represents a rare event. This study aims to characterize a larger cohort of carcinomas with DEK-AFF2 fusions to assess whether they truly constitute a distinctive entity. Among 27 sinonasal and skull base nonkeratinizing squamous cell carcinoma that were negative for human papillomavirus and Epstein-Barr virus, RNA sequencing identified DEK-AFF2 fusions in 13 cases (48%).
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