Background: Colloid cysts (CCs) are a rare type of benign tumor, and the ones >30 mm in diameter are determined as giant CCs. The giant CCs of the cavum septum pellucidum (CSP) are located in the hard-to-reach areas of the brain, and they can be removed microsurgically and endoscopically. At present, the transition from the microsurgical resection to the endoscopic is observed, and researchers demonstrate several benefits of the endoscopic resection over the microsurgical. We noticed the absence of research illustrating the endoscopic resection of the giant CC of the CSP. Therefore, we decided to demonstrate a rare case performed in our hospital. Case Description: Our patient was a 57-year-old male who had suffered from dizziness, headache, nausea, urinary incontinence, short-term forgetfulness, gait ataxia, cognitive decline, and vision blurring. The eventual diagnosis of the giant CC in the CSP was established, and it was complicated by occlusive hydrocephalus and headache syndrome. The endoscopic resection of the giant CC in the septum pellucidum was performed using the endoscopic transseptal approach. Conclusion: No complications were observed in the postoperative period. The tumor was removed completely, no recurrence was noted, and only a capsule of the tumor was observed in the control magnetic resonance imaging image taken 3 months after the operation. Considering these results, we conclude that endoscopic removal may have positive and safe outcomes as the surgical treatment method for the giant CCs located in the septum pellucidum.

Background: Metastatic tumors of the lumbar spine are a common complication of advanced malignancies. They often present with severe pain, neurological deficits, and spinal instability. Surgical removal of L5 vertebral body metastases is challenging due to the complex anatomy and biomechanical characteristics of the lumbosacral junction. Corpectomy using a combined approach is a common surgical strategy for achieving pain relief, adequate tumor resection, spinal cord and root decompression, and spinal stabilization. However, this approach may be associated with significant surgical trauma and blood loss. In this case report, we describe a surgical technique aimed at pain relief, mechanical stabilization, neurological preservation, and prevention of severe complications. Case description: A 62-year-old man with hepatocellular carcinoma presented with severe lumbar pain radiating to the left lower extremity, progressive lower limb weakness, and sensory deficits. Neurological examination revealed muscle strength of 3/5 in the lower extremities, Frankel grade C, and a Karnofsky Performance Status score of 40%. MRI and CT demonstrated metastatic destruction of the L5 vertebral body with spinal instability. The patient underwent a two-stage surgical procedure consisting of posterior minimally invasive percutaneous transpedicular fixation at the L4–S1 levels followed by mini-open anterior L5 corpectomy and anterior column reconstruction using a VLIFT titanium cage. Conclusion: The surgical procedure was performed without intraoperative complications. Total operative time was 4 h with an estimated blood loss of 800 mL. The patient was mobilized on the first postoperative day. Significant clinical improvement was observed: pain reduction from 8/10 to 2–3/10 on the Visual Analogue Scale and improvement in Karnofsky Performance Status from 40% to 80%. Postoperative CT confirmed adequate placement of the instrumentation and preservation of the posterior spinal column. Mini-open anterior L5 corpectomy combined with posterior minimally invasive percutaneous fixation may be a feasible surgical strategy for patients with L5 vertebral body metastasis. Preservation of the posterior spinal column may contribute to early mobilization, pain relief, and improved postoperative functional outcomes.