Transcallosal removal of craniopharyngiomas within the third ventricle

Six cases of craniopharyngioma located wholly, or largely, within the third ventricle are described; these include four adults with tumors completely within the ventricular system and two children with recurrent tumors primarily within the third ventricle. Four of these patients were operated on by a transcallosal approach. Gross total removal was possible in all patients, but two have suffered recurrence and only one is alive and tumor free. There were no signs or symptoms present preoperatively that allowed the intraventricular nature of the neoplasm to be correctly diagnosed. Air encephalography provided definitive tumor localization in each case. Three patients died of massive gastrointestinal hemorrhage in the immediate postoperative period. The surgical technique of transcallosal approach for removal of these neoplasms is described in detail.