Delayed cervical spine metastasis from intracranial solitary fibrous tumor

Cervical spine metastasis from primary intracranial solitary fibrous tumors (SFTs) is an extremely rare clinical entity. This report focuses on its metastatic tendency, radiological imaging, management plan, and follow-up strategies in view of its long latency period for metastasis. A 35-year-old female presented with right-side cervical radiculopathy. Magnetic resonance imaging spine showed C7 vertebral body collapse with retropulsion and neural compression. Two years ago, the patient had surgical resection of intracranial SFT (World Health Organization grade 3) with no evidence of recurrence on follow-up imaging. Cervical C7 metastasis has been decompressed and fused by the anterior cervical approach. Histopathology confirmed SFT metastasis to the spine, and the patient received adjuvant radiotherapy. Cervical metastasis from well-controlled primary intracranial SFT poses a significant challenge for its diagnostic and management planning. Serial pre-emptive surveillance is warranted with regular imaging and appropriate patient counseling.