Abstract
The authors describe the unusual case of a 6-year-old boy presenting with decorticate posturing, diminished hearing, and an inability to open his eyes, despite being verbally responsive. He underwent a posterior interhemispheric transcallosal intervenous approach for resection of a pineal region mature teratoma, which recurred 2 years postoperatively. This video demonstrates his initial surgery and reresection, illustrating the value of this approach for more complex lesions that involve the internal cerebral veins (ICVs). At the time of recurrence, microsurgical dissection of the scarred interhemispheric fissure was required to facilitate removal of the multifocal recurrent teratoma, resulting in gross-total resection.The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2134.
Highlights
We describe a posterior interhemispheric transcallosal approach for resection of a recurrent pineal region teratoma
The patient was a 6-year-old male who initially presented to an outside hospital with headaches and was found to have a pineal region mass with obstructive hydrocephalus
The diagnosis was consistent with a mixed germ cell tumor, and the patient underwent two cycles of chemotherapy, but his exam declined and subsequent imaging demonstrated rapid enlargement of the mass
Summary
The authors describe the unusual case of a 6-year-old boy presenting with decorticate posturing, diminished hearing, and an inability to open his eyes, despite being verbally responsive He underwent a posterior interhemispheric transcallosal intervenous approach for resection of a pineal region mature teratoma, which recurred 2 years postoperatively. This video demonstrates his initial surgery and reresection, illustrating the value of this approach for more complex lesions that involve the internal cerebral veins (ICVs). Follow-up imaging at that time revealed postoperative changes without evidence of recurrence to date
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