• Daniel Ameen, Kantha Siddhanth Gujjari, Bi Yi Chen, Fidel Toomey, Jeremy Kam, and Idrees Sher.
• Monash Medical School, Monash University, Melbourne, Victoria, Australia. Electronic address: Daniel.ameen@outlook.com.
• World Neurosurg. 2025 Jan 29: 123715123715.

BackgroundSpinal metastasis from salivary gland malignancies is a rare clinical entity with only several reports in the literature. There is no clear guidance for its optimal management.MethodsA systematic review was conducted following PRISMA guidelines. Databases including Medline, Cochrane, and Embase were searched for cases of spinal metastasis from major salivary gland malignancies. A case report of spinal metastasis from salivary duct carcinoma at our institution supplemented the review.ResultsThe review included 19 patients with a mean age of 54 years. Patients exhibited varied histopathological subtypes with acinic cell carcinoma and adenoid cystic carcinoma being the most common histopathology. Metastasis appeared from 0 to 35 years after primary diagnosis, with a mean of 11 years. The thoracic spine was most commonly affected (63%), followed by the lumbar spine (33%). Most metastases were osteolytic (79%). Vertebral body involvement was seen in 89% of cases, with significant collapse in 37%. Surgical management was required in 79% of cases, often combined with radiotherapy (63%) and chemotherapy (26%). Surgery generally led to neurological improvement in 80% of cases.ConclusionSpinal metastasis from salivary gland malignancies necessitates a comprehensive and multidisciplinary treatment approach due to the complex nature and variability in presentation. Long-term follow-up is essential for early detection and management of spinal metastases, given the extended latency period observed in many cases. The potential for metastasis is not solely dependent on tumor grade, emphasizing the need for ongoing vigilance in all patients with salivary gland malignancies.Copyright © 2025. Published by Elsevier Inc.

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