Unresectable Foramen Magnum Meningioma Treated With CyberKnife Robotic Stereotactic Radiosurgery

Meningiomas are tumors that originate from the meningeal or dural cover of the brain and are the most common primary benign brain tumors. Currently, the accepted management of these tumors is attempted total surgical excision when technically possible and associated with an acceptable risk. However, radiation therapy has been shown to provide excellent local control when used either as an adjunct to surgery or as a primary treatment. We present a case report of a 46-year-old female patient with an unresectable left foramen magnum meningioma resulting in headaches, neck pain, and swallowing difficulty. The patient underwent CyberKnife (Accuray Incorporated, Sunnyvale, CA) radiosurgery to a dose of 3,000 cGy in five fractions in March 2011. The patient tolerated treatment without complications and has remained clinically well with no ongoing cranial nerve deficits as of the last examination in late 2019. This demonstrates the excellent local control obtained when using radiosurgery as both a surgical adjunct and a primary treatment for meningiomas.