Background:There are few cases of choriocarcinoma metastases to the spine that have been reported. Most occurrences are in women with the gestational form of the tumor, and these now exhibit a very high remission rate with chemotherapeutic treatment, typically circumventing the need for spinal surgery.Case Description:In an effort to better understand treatment options for those rare instances when choriocarcinoma does find its way into the spine, we have synthesized a comprehensive literature review on the clinical cases of choriocarcinoma spinal metastases. We also describe our unique experience and decision-making involving the first reported case of surgical treatment of non-gestational choriocarcinoma spinal metastases in a male patient.Conclusion:Spinal surgery has a limited role in metastatic choriocarcinoma, but there is the potential for improving neurologic decline even in the rare and aggressive male variant of this disease.