Primary isolated ectopic cerebellopontine angle craniopharyngioma: diagnostic considerations, function-oriented...

Primary isolated ectopic cerebellopontine angle craniopharyngioma is rare and should be considered among cystic cerebellopontine angle lesions. A woman in her 70s presented with a 44-mm lesion extending into Meckel's cave, with progressive facial nerve palsy, bulbar dysfunction, and gait disturbance. Imaging revealed irregularly enhancing solid components within a homogeneous cyst, peripheral punctate calcifications, and low diffusion signal. Near-total resection was achieved through the retrosigmoid approach under continuous facial nerve monitoring, intentionally leaving adherent capsule. Pathological analysis confirmed adamantinomatous craniopharyngioma. Facial nerve function improved from House-Brackmann grade V to grade II, bulbar dysfunction and gait disturbance resolved, and no regrowth has occurred at 7 years. The video can be found here: https://stream.cadmore.media/r10.3171/2026.7.FOCVID2677.