Microscopic resection of a giant epidermoid tumor of the pineal region via supracerebellar infra and transtentorial approach with endoscope assistance

Marco Antônio Zanini; Aderaldo Costa Alves Junior; Fabio Pires Botta; Haniel Moraes Serpa Nascimento; Pedro Tadao Hamamoto Filho

doi:10.3171/2021.4.FOCVID2128

Microscopic resection of a giant epidermoid tumor of the pineal region via supracerebellar infra and transtentorial approach with endoscope assistance

Neurosurg Focus Video. 2021 Jul 1;5(1):V7. doi: 10.3171/2021.4.FOCVID2128. eCollection 2021 Jul.

Authors

Marco Antônio Zanini¹, Aderaldo Costa Alves Junior^{1

2}, Fabio Pires Botta¹, Haniel Moraes Serpa Nascimento¹, Pedro Tadao Hamamoto Filho¹

Affiliations

¹ Department of Neurology, Psychology and Psychiatry, Division of Neurosurgery, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, São Paulo, Brazil; and.
² Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.

Abstract

The authors present a case of a 22-year-old male who developed hydrocephalus symptoms related to a giant epidermoid tumor at the pineal region. The surgical approach and technique for a large epidermoid tumor in this area are extensively discussed. A paramedian contralateral supracerebellar infratentorial and transtentorial approach was performed, with the patient in a semisitting position. The tumor was removed using a microscopic technique, and endoscope assistance was used in order to reach the areas unable to be visualized under the microscope. The patient was neurologically intact at his 2-year follow-up, and postoperative MRI showed a significant decrease in the tumoral volume. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2128.

Keywords: endoscope assistance; epidermoid tumor; pineal region tumor; supracerebellar infratentorial approach.