| Summary: | The video describes the unusual interhemispheric subrostral approach to a teratoma of the anterior third ventricle. A five year old girl was referred to another hospital for diabetes insipidus. MRI showed a small enhancing mass in the anterior third ventricle and the patient was referred to our center for endoscopic biopsy that revealed immature teratoma. The lesion was resistant to chemotherapy because its size increased after three cycles, and the patient was referred again two months after endoscopic biopsy for surgical removal of the lesion. The different steps of the procedure are described: bilateral opening of the dura, section of the sagittal sinus, section of the falx, anterior interhemispheric dissection to reach the anterior communicating artery and the A2 complex, gentle lateral retraction of both A2 tracts to reveal the lamina terminalis, incision and opening of the lamina terminalis, dissection, debulking and removal of the tumor from the anterior third ventricle. MRI shows no residual tumor or regrowth at two-year follow up.
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