Contralateral Interhemispheric Transfalcine Approach for Supratentorial Extraventricular Ependymoma Resection

Background/Aim: Extraventricular supratentorial ependymomas are rare entities. Most ependymomas are located at the infratentorial and intraventricular level, and only in a small group of cases they do not present continuity with the ventricular system. This is a case report of a patient with an atypical location of a cerebral ependymoma, which required the implementation of a complex and infrequent approach for its complete microsurgical removal. Case Report: A 16-year-old male patient was referred at our department with a diagnosis of a 40 mm × 50 mm × 60 mm solid-cystic space-occupying lesion, sited between the left superior frontal-cingulate gyri. A contralateral transfalcine interhemispheric approach was selected, which achieved total resection of the tumor. The histopathological diagnosis of Grade II ependymoma was obtained according to WHO classification. Conclusion: The contralateral transfalcine interhemispheric approach represents a favorable surgical corridor to achieve a total resection of the tumor lesion and is favored by an adequate working angle and reduced brain manipulation.