Successful treatment of pediatric scalp mesenchymal tumor with NTRK rearrangement: a case report.
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BACKGROUND: Tumors with neurotrophic tyrosine receptor kinase (NTRK) rearrangements are rare in children, with an incidence rate of 3.1%. These tumors exhibit morphological and histological heterogeneity. Here, we report a rare case of pediatric scalp mesenchymal tumor with an NTRK rearrangement. CASE DESCRIPTION: A 3-year-old girl presented with a red, asymptomatic scalp mass detected 3 months prior to admission. Computed tomography revealed a large subcutaneous soft tissue mass with clear boundaries in the midline region of the scalp, with heterogeneous density and numerous dilated blood vessels around it. The mass was surgically resected after implanting a scalp expander. Pathological examination revealed a mesenchymal tumor with NTRK rearrangement and negative surgical margins at the periphery and base. Immunohistochemistry (IHC) revealed the following profile: CD34 (+) [anti-CD34 antibody (RM2052)], partial S-100 (+) [anti-S100 beta antibody (EP1576Y)-astrocyte marker], pan-tropomyosin receptor kinase (pan-TRK) (+) [anti-pan-TRK antibody (EPR17341)], and smooth muscle actin (SMA) (+) [alpha-SMA monoclonal antibody (1A4)]. Subsequently, on testing the tumor for a solid tumor gene panel by fluorescence in situ hybridization, it was found to be positive for NTRK3 (15q) fusion. The patient has remained recurrence-free at the 1-year follow-up and continues to be monitored. CONCLUSIONS: To the best of our knowledge, this is the first report of successful surgical excision of a pediatric scalp tumor with NTRK rearrangement. According to our research, this case represents the first reported successful surgical resection of a pediatric scalp tumor with NTRK rearrangement. This finding suggests that clinicians should pay attention to early diagnosis through molecular testing and recognize the feasible value of surgical resection in the treatment of this type of tumor.