# Resection of the tumor in the trigone of the lateral ventricle via the contralateral posterior interhemispheric transfalcine transprecuneus approach with multi-modern neurosurgery technology: a case report

## TL;DR

A rare case of choroid plexus papilloma in a child's brain was successfully treated using a novel surgical approach and modern neurosurgical tools.

## Contribution

The paper introduces the contralateral posterior interhemispheric transfalcine transprecuneus approach for accessing rare brain tumors in children.

## Key findings

- The contralateral PITTA approach provides a wider surgical angle and reduces optic radiation risks.
- Modern neurosurgical tools like intraoperative navigation and neuroendoscopy enhance accuracy and reduce complications.
- The case demonstrates successful tumor resection with minimal disturbance to surrounding brain structures.

## Abstract

Choroid plexus papilloma (CPP) is a rare benign intracranial tumor origin that predominantly manifests in the lateral ventricle in children, accounting for 0.3%–0.6% of all primary intracranial tumors. It is extremely rare to have the CPP in the trigone of the lateral ventricle through the contralateral posterior interhemispheric transfalcine transprecuneus approach (PITTA). Herein, we report this rare case. A 7-year-old girl presented with headache. Magnetic resonance imaging of the brain showed periatrial lesions, and histopathological examination confirmed CPP (WHO grade I). The contralateral PITTA is a safe, effective, reasonable, and appropriate for some lesions in the trigone of the lateral ventricle. It provides a wider surgical angle (especially for the lateral extension) and reduces the risk of disturbance of the optic radiation compared with the conventional approaches. The use of multiple modern neurosurgical techniques, including interventional embolization, intraoperative navigation, microscope, and electrophysiological monitoring, make the procedure much easier and more accurate, and the neuroendoscope adds to the visualization of the microscope and can reduce surgical complications.