Early isolated C7 vertebral body metastasis following temporal gliosarcoma resection: Pathophysiological insights and practice-oriented management framework.
- 1Department of Neurosurgery, Hassan II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, Morocco.
Abstract
Background
Gliosarcoma (GS) is a rare high-grade glioma characterized by a biphasic glial-mesenchymal histology. Compared with conventional glioblastoma, GS demonstrates a greater propensity for extracranial dissemination. However, isolated vertebral metastasis remains exceptionally uncommon.Case description
A 45-year-old man underwent gross-total resection of a left temporal GS followed by standard concomitant chemoradiotherapy. Baseline post-resection whole-body computed tomography (CT) staging was negative for systemic metastasis. Brain magnetic resonance imaging (MRI) at 5 months confirmed complete local intracranial control. At 6 months post-resection, he developed severe cervical pain and bilateral C7-C8 radiculopathy. Cervical MRI revealed destructive lysis of the C7 body with epidural extension causing severe spinal cord compression (Grade 3). Repeat systemic staging CT confirmed C7 as the solitary site of recurrence. An urgent anterior C7 corpectomy, expandable titanium cage placement, and plate stabilization were performed. Intraoperatively, the tumor was confined to the vertebral body, with an intact posterior longitudinal ligament and dura, strongly supporting hematogenous dissemination. Histopathology confirmed metastatic biphasic GS. Neurological decompression provided immediate pain relief and motor recovery.Conclusion
Vertebral metastasis from GS may occur early despite satisfactory intracranial control. New axial or radicular spinal symptoms should prompt early spinal imaging. In appropriately selected patients with neurological compression or mechanical instability, decompression and stabilization may provide rapid symptomatic and functional benefit despite the aggressive systemic course of the disease.
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BibTeX
@article{hmamouche2026early,
title = {{Early isolated C7 vertebral body metastasis following temporal gliosarcoma resection: Pathophysiological insights and practice-oriented management framework.}},
author = {Oualid Mohammed Hmamouche and Mehdi Mdarhri and Hamza Sriri and Marouane Hammoud and Faycal Lakhdar and Mohammed Benzagmout and Khalid Chakour and Mohammed El Faiz Chaoui},
journal = {Surgical neurology international},
year = {2026},
month = oct,
doi = {10.25259/sni_939_2026},
url = {https://europepmc.org/article/MED/42974540},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Early isolated C7 vertebral body metastasis following temporal gliosarcoma resection: Pathophysiological insights and practice-oriented management framework.
AU - Oualid Mohammed Hmamouche
AU - Mehdi Mdarhri
AU - Hamza Sriri
AU - Marouane Hammoud
AU - Faycal Lakhdar
AU - Mohammed Benzagmout
AU - Khalid Chakour
AU - Mohammed El Faiz Chaoui
PY - 2026
DA - 2026/10/23
JO - Surgical neurology international
DO - 10.25259/sni_939_2026
UR - https://europepmc.org/article/MED/42974540
AB - Background Gliosarcoma (GS) is a rare high-grade glioma characterized by a biphasic glial-mesenchymal histology. Compared with conventional glioblastoma, GS demonstrates a greater propensity for extracranial dissemination. However, isolated vertebral metastasis remains exceptionally uncommon.Case description A 45-year-old man underwent gross-total resection of a left temporal GS followed by standard concomitant chemoradiotherapy. Baseline post-resection whole-body computed tomography (CT) staging was negative for systemic metastasis. Brain magnetic resonance imaging (MRI) at 5 months confirmed complete local intracranial control. At 6 months post-resection, he developed severe cervical pain and bilateral C7-C8 radiculopathy. Cervical MRI revealed destructive lysis of the C7 body with epidural extension causing severe spinal cord compression (Grade 3). Repeat systemic staging CT confirmed C7 as the solitary site of recurrence. An urgent anterior C7 corpectomy, expandable titanium cage placement, and plate stabilization were performed. Intraoperatively, the tumor was confined to the vertebral body, with an intact posterior longitudinal ligament and dura, strongly supporting hematogenous dissemination. Histopathology confirmed metastatic biphasic GS. Neurological decompression provided immediate pain relief and motor recovery.Conclusion Vertebral metastasis from GS may occur early despite satisfactory intracranial control. New axial or radicular spinal symptoms should prompt early spinal imaging. In appropriately selected patients with neurological compression or mechanical instability, decompression and stabilization may provide rapid symptomatic and functional benefit despite the aggressive systemic course of the disease.
SN - 2229-5097
SN - 2152-7806
ER -