Foramen magnum metastatic malignant melanoma

The foramen magnum as a site for brain metastasis is extremely rare. We report the case of a 24-year-old male who presented with features of increased intracranial pressure and lower cranial nerve palsies. Imaging revealed a foramen magnum tumor with extension up to the cerebellar vermis superiorly and into the spinal canal inferiorly (craniospinal mass) with mild obstructive hydrocephalus. A malignant melanoma was completely excised. The patient continued to be tumor-free 24 months later.