Petrous apex meningioma – upfront radiosurgery

SKULL BASE REGION	Petrous apex
HISTOPATHOLOGY	N/A
PRIOR SURGICAL RESECTION	No
PERTINENT LABORATORY FINDINGS	N/A

Case description

The patient is a 55-year-old patient with a few years history of progressive hearing loss who was evaluated for an acute episode of subjective dizziness. Audiometry showed bilateral moderate-to-severe hearing loss, with a pure tone average of 42.5 dB in the right ear. Brain MRI revealed a right petrous ridge/petrous apex tumor compatible with a meningioma ( Figure 7.29.1 ). Given the location and size of the lesion, upfront treatment with stereotactic radiosurgery (SRS) or surgical resection were offered to the patient; he opted for SRS because of the absence of symptoms related to the tumor and low risk of posttreatment deficits. A single-session SRS was performed using CyberKnife ( Figure 7.29.2 ).