Microsurgical Resection and Posterior Stabilization of a Delayed Solitary Thoracic Vertebral Metastasis From a Malignant Triton Tumor: A Case Report.

Malignant triton tumor (MTT) is an aggressive variant of malignant peripheral nerve sheath tumor (MPNST) characterized by rhabdomyoblastic differentiation and an unfavorable prognosis. Spinal metastases from this tumor are exceptionally uncommon, and management strategies remain unstandardized and largely based on anecdotal evidence. This report presents the case of a 37-year-old woman with a history of retroperitoneal MTT that had been radically resected (R0). The patient developed gradually progressive thoracic back pain without neurological deficit. Magnetic resonance imaging revealed a destructive lesion of the T10 vertebral body consistent with an isolated metastatic focus, with no signs of local recurrence at the primary tumor site. Following a multidisciplinary discussion, surgical treatment was performed without prior biopsy. Microsurgical resection of the vertebral lesion with posterior stabilization from T9 to T11 was successfully completed. Postoperatively, the patient experienced significant pain relief and preserved neurological function. Histopathological examination confirmed metastatic MTT. During follow-up, systemic disease progression was observed; however, local spinal control remained stable. Two years after surgery, there was no evidence of local recurrence or instrumentation failure. This case highlights the potential role of surgical management in selected patients with isolated spinal metastasis from MTT to achieve durable local control and functional preservation.