Intracranial metastasis from primary spinal primitive neuroectodermal tumor.

Area of Science:

• Neuro-oncology
• Spinal Cord Tumors
• Neurosurgery

Background:

• Primary spinal primitive neuroectodermal tumors (PNET) are rare, with fewer than 100 cases documented.
• Intracranial metastasis from a spinal PNET is an exceedingly rare occurrence.

Observation:

• A 22-year-old female with a history of cervicothoracic spinal PNET presented with headache and left hemiparesis.
• Imaging revealed a solitary right parietal parasagittal brain tumor, confirmed as PNET upon resection.
• The patient had previously undergone surgery, radiotherapy, and chemotherapy for the primary spinal tumor seven years prior.

Findings:

• The intracranial metastasis was surgically removed, followed by radiotherapy and chemotherapy (ifosfamide and etoposide).
• At 20 months post-treatment, the patient remains disease-free with no recurrence.
• Pathological examination confirmed the metastatic lesion as PNET.

Implications:

• This case underscores the possibility of late intracranial metastasis from spinal PNET.
• Aggressive multimodal treatment, including surgery, radiotherapy, and chemotherapy, can achieve favorable outcomes in rare cases of spinal PNET brain metastasis.
• Further review of similar rare cases is warranted to refine treatment strategies.