• Jordan B Fenlon, Mohamed H Khattab, Donna C Ferguson, Guozhen Luo, Vicki L Keedy, Lola B Chambless, and Austin N Kirschner.
• Western Michigan University School of Medicine, Kalamazoo, Michigan, USA.
• World Neurosurg. 2019 Mar 1; 123: 123-127.

BackgroundMalignant peripheral nerve sheath tumors (MPNSTs) are rare, aggressive soft tissue sarcomas. MPNST intracranial metastasis is exceedingly rare with only 22 documented cases in the literature and, to our knowledge, only 1 case with intraparenchymal brain metastasis. Most have been managed surgically; however, 2 documented cases were treated with Gamma Knife radiosurgery. Excluding this case report, there are no other documented cases of linear accelerator-based stereotactic radiosurgery (SRS) to treat MPNST brain metastasis.Case DescriptionA 41-year-old man with MPNST of the lung initially underwent tumor resection. He developed multiple systemic metastases that were managed with directed radiation therapy. A parietal brain metastasis was treated with linear accelerator-based SRS. Following SRS therapy, the patient was treated with a tropomyosin receptor kinase inhibitor. Complete resolution of brain metastasis was seen on brain magnetic resonance imaging 5 months after treatment with SRS. At 11 months after SRS, there was no evidence of recurrence or progression of the intraparenchymal disease. The patient continued to have stable extracranial disease on his ninth cycle of systemic treatment.ConclusionsThis report provides important insights into efficacy of linear accelerator-based SRS to treat MPNST brain metastases.Copyright © 2018 Elsevier Inc. All rights reserved.

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