Background: The surgical resection of the large fourth ventricle choroid plexus papilloma (CPP) is complicated, where the challenge is to minimize the impairment of the vermis and the brainstem and restore the cerebrospinal fluid circulation.
Method: We report a case of large CPP that wholly occluded the fourth ventricle, extended to the Luschka foramen, and underwent radical resection via telovelar approach. The intraoperative endoscope was applied to inspect the tumor residue and the aqueduct's opening.
Conclusion: This case demonstrates the surgical nuance of the fourth ventricle CPP.
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