PMC8418180_01
PMC8418180_02
contrasted head CT scan; A) showing an isodense mass within the third ventricle with mild rim contrast enhancement and spot calcification. Contrasted axial; B) sagittal C) coronal; D) T1-weighted MR images showing a bilobate cystic lesion encompassing the third ventricle and the left frontal horn with fluid-fluid level and mild rim contrast enhancement; this lesion contains both hypointense and hyperintense components in FLAIR; E) and in apparent diffusion coefficient map; F) note the debris in the occipital horns of the lateral ventricles with a fluid-fluid level (white arrow)
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F1
Monro bilaterally and extending to the left frontal horn with a mild rim contrast enhancement and small calcifications, associated with an obstructive hydrocephalus (Figure 1). Magnetic resonance imaging (MRI) disclosed a bilobate lesion including a cystic part of 23mm of diameter extending from the third ventricle to both of the foramen of Monro and a second heterogenous part in the left frontal horn of the lateral ventricle. In addition to the obstructive hydrocephalus, there were deposits in the occipital horns of the lateral ventricles (Figure 1).
A) intra-operative endoscopic view of the lesion encompassing the foramen of Monro; B) signs of ventriculitis; C) and a cluster of pus in the frontal horn of the left lateral ventricle
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F2
On endoscopic visualization, the lesion was spherical, extending from the septum pellucidum to the third ventricle and encompassing the foramens of Monro (Figure 2).
intra-operative image of the lesion seen through a right transcortical transventricular approach
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F3
The lesion was highly adherent to the fornix, preventing a complete excision of the wall (Figure 3).