Transparent 3D-printed brain tumor model integrating tractography for planning minimally invasive transcortical resection of an intraventricular meningioma: A case report.

Background: Defining the optimal surgical approach for atrial intraventricular meningiomas remains challenging, particularly for dominant hemisphere lesions adjacent to eloquent pathways. While three-dimensional (3D)-printed models have been applied in neurosurgery for education and skull base pathology, integration of white matter tractography into these models to assist with approach selection for intraventricular tumors remains limited. Case Description: A 40-year-old woman presented initially with headaches and progressive visual disturbances. Neuro-ophthalmologic evaluation demonstrated papilledema and a right homonymous hemianopsia, and magnetic resonance imaging revealed a large 7-cm enhancing mass centered within the atrium of the left lateral ventricle, most consistent with an intraventricular meningioma. During the 6-month interval between diagnosis and surgical intervention, she developed progressive memory impairment and word-finding difficulty. A patient-specific 3D-printed model incorporating transparent parenchyma and semi-transparent representations of the corticospinal tract, language network, and optic radiations was created using a detachable, sliced design. Standardized survey responses from attending and resident surgeons suggested the model improved spatial understanding of the tumor's relationship to surrounding neurovascular structures and helped inform trajectory selection. A minimally invasive posterior temporoparietal tubular transcortical approach was selected, and radiographic gross total resection was achieved. Pathology confirmed a central nervous system World Health Organization Grade 2 atypical meningioma. Conclusion: A transparent, modular 3D-printed model integrating patient-specific tractography may serve as a useful adjunct for preoperative planning of minimally invasive transcortical approaches to deep-seated intraventricular tumors. This design may improve intuitive visualization of complex three-dimensional anatomical relationships during trajectory planning; however, its independent effect on operative decision-making and clinical outcomes requires prospective evaluation.