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Key Clinical Message: Regarding head immobilization practices in neurosurgery, secondary fixation fractures are rare, underscoring the importance of precise pin positioning and an adequate force in the three‐point clamp to achieve adequate fixation. Attention should be given to factors such as changes in bone metabolism. [ABSTRACT FROM AUTHOR]

Background: Myxofibrosarcoma (MFS) is a type of sarcoma that mainly affects elderly people; it represents only 5% of all sarcomas and shows no line of differentiation. Intracranial MFS is a rare condition. At present, limited data exist regarding brain metastasis from MFS. This article reports a case of MFS and reviews the literature regarding MFS metastasis. Case Description: We report a case of brain metastasis from chest wall MFS. The patient was diagnosed with an anterior thoracic MFS and underwent surgery and radiotherapy. One year later, he noticed a tumor on his left shoulder, and more than 1 year thereafter, bilateral lung metastasis was observed. Twelve months after lung metastasis, he presented to the emergency department and underwent contrast-enhanced magnetic resonance imaging, which demonstrated a left frontal tumor suggestive of brain metastasis. Since the main hypothesis was a sarcoma metastasis at the location close to the left motor area, and the patient had a good Karnofsky performance scale, the patient underwent neuronavigation-guided surgery. After surgery, the patient developed Grade III hemiparesis and aphasia. Brain tumor histopathology confirmed a malignant neoplasm with osteosarcomatous differentiation and metastasis from MFS. Conclusion: We report a rare case of MFS metastasis. To the best of our knowledge, this is the eighth case of intracerebral metastasis from MFS. [ABSTRACT FROM AUTHOR]