A case of pineal germinoma required reoperation 3 years after endoscopic third ventriculostomy

We report a case of stoma obstruction 3 years after endoscopic third ventriculostomy. A 13-year-old male had received endoscopic third ventriculostomy for obstructive hydrocephalus due to pineal germinoma. Germinoma was thought diagnosed by endoscopic finding and treated by chemotherapy and stereotactic radiosurgery. After that, the tumor disappeared completely and there was no recurrence. Three years after treatment, the patient experienced headache and visual disturbance. Neurologic examination showed papilledema and MRI showed ventricular dilatation, disappearance of the flow void at the third ventricle, and dullness of infundibular recess angle, which indicated closure of the stoma. The patient received endoscopic third re-ventriculostomy and his symptoms improved. We discussed strategies for failure of endoscopic third ventriculostomy. endoscopic third re-ventriculostomy.