Sinonasal Nonkeratinizing Squamous Cell Carcinoma with Synchronous Presence of HPV-High Risk and MKRN1::BRAF Fusion

An increased understanding of molecular alterations over the last decade has also impacted the landscape of sinonasal squamous cell carcinoma (SNSCC). In addition to traditional SCC risk factors (e.g. smoking) and high-risk HPV (HR- HPV), other drivers are emerging, such as DEK::AFF2 fusion in non-keratinizing and papillary SNSCC. Treatment of squamous cell carcinoma has been revolutionized with development of drugs that target key driver mutations and immune checkpoints. We describe a case report of nasal nonkeratinizing squamous cell carcinoma- HPV-high risk (HPV-HR) positive and harboring an MKRN1::BRAF fusion. We further discuss the significance of these findings, integrated in the context of current literature.