Endoscopic endonasal management of giant pediatric craniopharyngioma

A 13-year-old girl with growth deceleration and multiple endocrinopathies was found to have a giant adamantinomatous craniopharyngioma with hydrocephalus. She underwent an endoscopic endonasal approach with gross-total resection of the tumor with preservation of the hypothalamus. Postoperatively she developed expected panhypopituitarism given pituitary stalk involvement but had no neurological deficits. On 3-year follow-up, there was no tumor recurrence, hypothalamic dysfunction, or hydrocephalus. Pediatric craniopharyngioma remains challenging to manage given complex patterns of spread and proximity to critical neurovascular structures. Advancements in endoscopic techniques have allowed for dynamic visualization and excellent suprasellar access with high cure rates and low morbidity. The video can be found here: https://stream.cadmore.media/r10.3171/2026.7.FOCVID2656.