Resection of a Giant Immature Teratoma of the Third Ventricle with Transcallosal-Transchoroidal Approach

Primary central nervous system (CNS) germ cell tumors (GCT) are a heterogeneous group of tumors that comprises approximately 1% of primary brain tumors in pediatric and young adult patients. They usually arise in pineal region ad are divided into germinomas, which are the most common subtype, and non-germinomatous germ cell tumors (NGGCTs) which include teratomas, embryonal carcinomas, choriocarcinomas and yolk sac tumors. GCTs can occur as pure or mixed subtypes; Teratomas can be classified further as mature, containing entirely fully differentiated tissues, or immature, containing mostly embryonic or fetal tissues.  While germinomas are radiation-sensitive tumors, all other tumors have less response to radiotherapy, and a gross total resection improves their overall survival and tumor-free survival rates. The video shows the resection of a current immature teratoma of the pineal region by transcallosal-transchoroidal approach with ultrasonic aspiration.