Contralateral Interhemispheric Transcallosal Transchoroidal Approach for Resection of a Tumor in the Lateral Wall of...

Third ventricular tumors pose a surgical challenge, given the intricate surrounding anatomy and depth of the surgical field. A surgical approach to these lesions can involve several different trajectories, the selection of which is dependent on the location of the tumor. Approaches include transforaminal, translamina terminalis, interforniceal, occipital transtentorial, endoscopic transventricular, transchoroidal, and supracerebellar infratentorial. This patient had a metastatic lesion within the lateral wall of the third ventricle. The selection of the surgical approach was dependent on the laterality of the tumor. The foramen of Monro was identified, and landmarks were confirmed. The choroid plexus could then be retracted medially, and the choroidal sulcus was identified. The sulcus was entered laterally to minimize the risk of transgressing the fornix. The tumor was identified along the lateral third ventricular wall, and the plane between the tumor and normal plane was readily created. The tumor was then removed entirely, and postoperative imaging demonstrated a complete resection. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.