Midline supratentorial tumors

Tumors of the supratentorial midline are common in children and are often amenable to an aggressive operative resection. MR imaging is invaluable to planning an operative strategy. A variety of surgical corridors provide access to the deep midline structures, notably the transcallosal, transventricular, and basal routes. The histology is important in determining the value of adjuvant treatments, such as radiation therapy and chemotherapy. These complex tumors are best managed by a multidisciplinary group with a special interest in pediatric neuro-oncology.