거대 두개인두종에 대한 2단계 수술

A two-staged operation for the giant craniopharyngioma: Endoscopy-assisted interhemispheric approach and transcallosal approach

Giant craniopharyngiomas (CPs) present a challenge for neurosurgeons in terms of treatment. The complex clinical course, which includes both surgical and non-surgical aspects, remains a significant hurdle to overcome. While most CPs are treated using an endoscopic endonasal approach regardless of their size, skull base reconstruction to prevent cerebrospinal fluid leakage becomes a subsequent concern after surgery. In this case report, we present a giant CP that occupies the anterior cranial fossa, third ventricle, and posterior fossa, extending as low as the internal acoustic meatus level. We conducted a two-staged operation, consisting of the endoscope-assisted interhemispheric approach and the transcallosal approach, to remove the tumor. The endoscopic view provided a unique anatomical perspective of the tumor, cranial nerves, vessels, and Liliequist membrane.