Case Report: Malignant peripheral nerve sheath tumor of the thoracic spine with postoperative recurrence and intracranial metastasis—a review of the literature

TL;DR

This case report describes a rare and aggressive spinal tumor that quickly recurred and spread to the brain, emphasizing the need for early detection and vigilance.

Contribution

The paper presents a unique case of rapid MPNST recurrence and brain metastasis, highlighting atypical metastatic routes.

Findings

The tumor recurred three months after surgery and metastasized to the brain within two months.

Histological confirmation showed metastatic MPNST in the intracranial lesion.

The case suggests the need for multimodal strategies to detect brain metastasis early.

Abstract

Malignant peripheral nerve sheath tumors (MPNSTs) are uncommon and biologically aggressive sarcomas. Although primary involvement of the thoracic spine is rare, the occurrence of intracranial metastasis typically indicates advanced-stage disease and portends a poor prognosis. We report a unique case of a 64-year-old man with a primary thoracic spinal MPNST that recurred three months after surgery and developed intracranial metastasis within two months. Initial imaging revealed a subdural lesion at the T11–T12 level. Postoperative histopathology confirmed MPNST with a Ki-67 index of 50%. Shortly after surgery, the tumor recurred locally and metastasized to the left parietal lobe. Histological examination of the intracranial lesion confirmed metastatic MPNST. This case highlights the potential for MPNST to metastasize to the brain via atypical routes, underscoring the importance of heightened clinical vigilance and the need for multimodal strategies to detect brain metastasis at an early stage.

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