Endoscopic transorbital approach to posterior fossa recurrent craniopharyngioma

Recurrent craniopharyngiomas represent a complex neurosurgical challenge. These histologically benign lesions show aggressive behavior that frequently recurs. The aim in treatment is to achieve an optimal balance between local control and quality of life. However, no agreement on the management of recurrent cases exists. Different surgical strategies are utilized for the management of these lesions using transcranial or endoscopic approaches. The authors present the case of a 38-year-old man with a large recurrent craniopharyngioma, previously treated with several endonasal interventions, responsible for headaches and unsteady gait. The recurrent cystic portion of the tumor, invading the pons, was treated using an endoscopic transorbital approach. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24177.