• Ariana S Barkley, Chao-Hung Kuo, Sarah E S Leary, Jeffrey G Ojemann, and Srinivas M Susarla.
• Department of Neurological Surgery, University of Washington, Seattle, Washington, USA. Electronic address: arianab@uw.edu.
• World Neurosurg. 2019 Feb 1; 122: 81-84.

BackgroundPrimary intracranial teratomas account for <1% of intracranial masses during childhood after infancy. When supratentorial, they commonly occur in the pineal and suprasellar regions, demonstrating multilocularity, areas of fat, and calcifications and increasing enhancement correlating with decreased maturity. However, the presence of a teratoma as a mobile fat lesion within a large unilocular suprasellar cyst is rarely documented in this patient population.Case DescriptionWe present the first pediatric case of a suprasellar mature teratoma presenting as a mobile fat suppressing lesion within a large unilocular suprasellar cyst and describe a supraorbital approach with adjunctive use of the endoscope for resection. We also provide a literature review of other cases presenting with similar radiographic findings.ConclusionsMature teratomas may manifest atypically as unilocular cystic lesions with a central mobile fatty component and are treated by gross total surgical resection. The supraorbital approach with adjunctive use of an endoscope can provide adequate exposure for resection with optimal cosmetic outcome.Copyright © 2018 Elsevier Inc. All rights reserved.

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