Tuberculum Sella Meningioma with Vascular Encasement

A 42-year-old man presented with severe left visual loss and right temporal field cut. Imaging showed a tuberculum sella meningioma with anterior cerebral artery encasement. The patient underwent an endoscopic endonasal approach with accurate tumor dissection from both optic canals and left A1 segment. Gross total resection was obtained with improvement of right visual acuity. This case illustrates technical nuances to deal with severe optic canal invasion and vascular encasement in endonasal endoscopic surgery.