A 44-year-old male developed chronic cancer pain caused by a progressive desmoplastic melanoma involving the mandibular division of the trigeminal nerve. The patient had failed local resection, conformal radiation therapy and chemotherapy, but was eligible for stereotactic radiosurgery using a new technology. Intraoperative stereotactic magnetic resonance and computed tomography imaging were fused to define the tumor volume and to create a conformal radiosurgery dose plan. The radiosurgery target volume was 8.6 ml. A marginal dose of 17 Gy at the 50% isodose was prescribed. The entire procedure was performed on an outpatient basis. The Leksell Gamma Knife® Perfexion™ technology increases the spectrum of treatable pathologies located in the cranial base and head and neck regions.

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