Percutaneous vertebroplasty is gaining acceptance as the standard of care for patients with painful osteolytic metas-tases of the spine who do not respond to conventional therapy. Injection of acrylic cement was proved to be effective in pain relief by stabilizing the vertebral body; this clinical outcome could also be achieved in difficult cervical vertebrae even if percutaneous vertebroplasty on the body of Cl was previously reported in only two cases . Metastases located on Cl needing stabilization are extremely rare, and the most common surgical option for atlas neoplasms (reported in few case reports and case series most frequently for primary tumors such as chordoma or meningioma) is resection eventually followed by occipito-cervical fusion.
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