ABSTRACT
Neoplastic conditions of the craniocervical region are uncommon. Primary tumors arising
at the craniocervical junction include meningiomas, neurinomas, and chordomas. Metastatic
disease is exceedingly uncommon at the craniocervical junction, but may involve the
atlantoaxial region. The clinical presentation of primary tumors of the craniocervical
region is generally that of slowly progressive neurologic dysfunction.
The clinical characteristics of metastatic disease of the atlantoaxial region are
markedly different from those of metastatic disease of the subaxial cervical spine
because of differences in regional anatomy and biomechanics. Metastatic lesions of
C1 and C2 most frequently present with severe pain and only rarely with neurologic
involvement.
Optimal treatment is dependent on the tumor location and pathology. Primary tumors
often require surgical resection, although complete resection is difficult because
of the location and intimate involvement of adjacent structures. Goals of treatment
for patients with atlantoaxial metastatic disease are stabilization of the spine,
prevention of neurologic deterioration, maintenance of mobility, and amelioration
of pain.
KEYWORDS
Neoplasm - craniocervical - atlanto-axial
