Endoscopic Ipsilateral Posterior Interhemispheric Transprecuneus Approach for Central Neurocytoma

The optimal treatment strategy for central neurocytoma remains controversial due to their rare occurrence, specificity, and complexity. This study was conducted to explore the surgical technique and feasibility of the endoscopic ipsilateral posterior interhemispheric transprecuneus approach (IPITA) for the treatment of central neurocytoma in the lateral ventricle.

A retrospective analysis was performed on the clinical data and follow-up outcomes of 12 patients who underwent the resection of central neurocytoma with IPITA at our center from July 2018 to July 2025.

Total resection was achieved in 11 cases, whereas subtotal resection (STR) occurred in 1 case. Among these patients, 2 developed postoperative hydrocephalus; one improved after a ventriculoperitoneal shunt, whereas the other recovered after undergoing septostomy. Postoperative radiotherapy was advised for patients with a Ki-67 index of ≥3% or STR. The follow-up period after surgery ranged from 12 to 72 months. One patient with STR did not receive radiotherapy due to the development of bilateral optic nerve atrophy 2 months postoperatively. The tumor recurred 30 months after surgery, at which point radiotherapy was administered. Throughout the follow-up period, the tumor did not show any signs of progression. The remaining 11 patients did not experience tumor recurrence during the follow-up period.

IPITA can effectively and safely resect central neurocytoma located in the lateral ventricle. This technique is particularly advantageous for tumors primarily situated in the posterior portion of the lateral ventricle body and/or those that involve the trigone of the lateral ventricle.