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Case Reports
. 2015 Mar 19;6(Suppl 2):S113-6.
doi: 10.4103/2152-7806.153653. eCollection 2015.

A flexible endoscope-assisted interhemispheric transcallosal approach through the contralateral ventricle for the removal of a third ventricle craniopharyngioma: A technical report

Shigetoshi Yano  1 , Takuichiro Hide  1 , Naoki Shinojima  1 , Yutaka Ueda  1 , Jun-Ichi Kuratsu  1
Affiliations
Case Reports

A flexible endoscope-assisted interhemispheric transcallosal approach through the contralateral ventricle for the removal of a third ventricle craniopharyngioma: A technical report

Shigetoshi Yano et al. Surg Neurol Int. .

Abstract

Background: Intraventricular craniopharyngiomas are difficult to remove. We combined an interhemispheric transcallosal approach with a flexible endoscope (videoscope) for successful tumor removal.

Case description: A 52-year-old male complained of general fatigue and memory disturbance. Magnetic resonance imaging revealed a well-enhanced third ventricle mass with dilatation of lateral ventricles. During removal with the interhemispheric transcallosal approach, a videoscope that was inserted into the left lateral ventricle revealed the interface of the tumor and the ventricular wall. The tumor was pushed to the right using forceps and removed totally through the right foramen of Monro without any fornix injury.

Conclusion: This procedure is a safe option for removing third ventricular tumors especially in the case with hydrocephalus.

Keywords: Craniopharyngioma; flexible endoscope; third ventricle; transcallosal approach; videoscope.

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Figures

Figure 1
Figure 1
Gadolinium (Gd)-enhanced magnetic resonance (MR) images. In the preoperative images, the tumor was homogeneously enhanced by Gd, which extended to the dorsal part in the third ventricle (a and b). The MR images obtained 5 days after the operation. The tumor was totally removed with mild enhancement of the ventricular wall reflecting postoperative changes (c and d)
Figure 2
Figure 2
Intraoperative images and photographs. (a): Schematic sketch of the combined surgical approach with a videoscope for the third ventricular craniopharyngioma. (b): Microscopic view of the tumor removal. The tumor (T) was dissected by a dissector (arrow heads) with the assistance of forceps through the contralateral videoscope (arrow). (c-e) Videoscopic view of the tumor removal through the contralateral ventricle. The tumor was pushed by the forceps (arrow) through the videoscope (c). The interface between the tumor and the left wall of the third ventricle was well observed (white arrowheads) (d). The tumor was almost removed. The anterior wall of the third ventricle (asterisk) was observed through the videoscope (e)
See this image and copyright information in PMC

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