There are no reported cases of RGNT within the third ventricle, although this tumor has also been described in the pineal region, the tectum and within the aqueduct 2 . Supratentorial localization is quite rare, with only three published: one was found in the septum pellucidum 3 , another within the optic nerve in neurofibromatosis type 1 (NF1) patient
BRIEF COMMUNICATIONSwere no other neurological symptoms. On examination, his cranial nerves were all intact with no papilloedma. The remainder of the exam showed normal power, reflexes, coordination, and sensation in both upper and lower extremities.Imaging. An initial non-contrast computed tomography (CT) scan of the head demonstrated obstructive hydrocephalus. Subsequent magnetic resonance imaging (MRI) of the brain (Figure 1), confirmed hydrocephalus but also demonstrated a lesion within the posterior aspect of the third ventricle. The lesion was isointense on T1 weighted sequences and hyperintense on T2 weighted sequences with a heterogeneous enhancement pattern following administration of gadolinium.Operation. Given the progressive nature of the patient's symptoms, a decision was made to proceed with endoscopic third ventriculostomy (ETV) and biopsy of the lesion. The procedure was done using a flexible endoscope (Storz). By flexing the endoscope underneath the massa intermedia of the thalami, the tumor was visualized in the aqueductal recess, attached to the right thalamus (Figure 2). Three small biopsy samples were obtained. The endoscope was then directed