Transcallosal approach for a giant third ventricle craniopharyngioma: illustrative case

Giant third ventricle craniopharyngiomas pose surgical challenges due to their deep location and critical neurovascular relationships. A 22-year-old woman presented with headache, bitemporal hemianopia, and memory impairment from a giant multicystic craniopharyngioma extending from the third ventricle into the left lateral ventricle with obstructive hydrocephalus. Using GRID 3D simulation, the authors compared four corridors; a transcallosal transforaminal approach was selected based on the enlarged foramen of Monro and medially displaced fornix. Gross-total resection was achieved, with marked visual and memory recovery and return to work. Patient-specific 3D simulation enables objective approach selection. The transcallosal route is effective for retrochiasmatic third ventricle craniopharyngiomas with hydrocephalus. The video can be found here: https://stream.cadmore.media/r10.3171/2026.7.FOCVID2686.