Rathke’s cleft cyst infections and pituitary abscesses: case series and review of the literature

Pituitary ◽  
2021 ◽  
Author(s):  
F. Aranda ◽  
R. García ◽  
F. J. Guarda ◽  
F. Nilo ◽  
J. P. Cruz ◽  
...  
Keyword(s):  
Case Series ◽  
Rathke’S Cleft Cyst ◽  
Review Of The Literature ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft

Relationship between Recurrence Rates of Rathke's Cleft Cysts and Surgical Approaches to Sellar Reconstruction

2020 ◽  
Author(s):  
Rebecca Limb ◽  
James King
Keyword(s):  
Recurrence Rate ◽  
Case Series ◽  
Redo Surgery ◽  
Rathke’S Cleft Cyst ◽  
Recurrence Rates ◽  
Rathke's Cleft Cyst ◽  
Study Objective ◽  
Cyst Recurrence ◽  
Rathke's Cleft ◽  
Sellar Floor

Abstract Study Objective The main purpose of this article is to address the question of whether reconstructing the sellar floor following Rathke's cleft cyst excision results in increased rates of recurrence. Methods and Design A retrospective case series was compiled from medical records and radiological investigations at a single institution over a time period spanning 25 years. Episodes of cyst recurrence were determined from magnetic resonance imaging scans and outpatient encounters. Details regarding surgical procedure and techniques were obtained from operation notes. Perioperative morbidity was also recorded. Results Twenty-three adult patients were treated surgically for a Rathke's cleft cyst at the study institution between 1992 and 2017. The overall cyst recurrence rate was 48%, with 39% of all patients requiring redo surgery within the timeframe of the study. The mean time to redo surgery for recurrence was 4 years. Cyst recurrence rates were 57% postmicroscopic procedures, and 26% postendoscopic procedures (p = 0.148). In the nonreconstructed group, the recurrence rate was 17%, and in the reconstructed group the recurrence rate was 41% (p = 0.3792). Complications arising after nonreconstructive procedures were delayed cerebrospinal fluid rhinorrhea, pneumocephaly, and multiple episodes of meningitis. All these patients required return to theater for secondary reconstruction of the pituitary fossa floor. Conclusion The results of this small study suggest that reconstruction of the sellar floor, and microscopic rather than endoscopic techniques, may be associated with a higher rate of Rathke's cleft cyst recurrence. However, these trends did not reach statistical significance. Patients undergoing nonreconstructive procedures may be more prone to certain postoperative complications.

scholarly journals Intrasphenoidal Rathke’s Cleft Cyst: Case presentation and review of the literature

2016 ◽  
Vol 30 (4) ◽  
pp. 520-525 ◽  
Author(s):  
Umit Kocaman ◽  
Muhammet Bahadir Yilmaz ◽  
Hakan Yilmaz
Keyword(s):  
Benign Lesion ◽  
Rathke’S Cleft Cyst ◽  
Review Of The Literature ◽  
Rathke's Cleft Cyst ◽  
Case Presentation ◽  
Prepontine Cistern ◽  
Autopsy Series ◽  
Pituitary Glands ◽  
Visual Problems ◽  
Rathke's Cleft

Abstract Rathke’s cleft cyst is a benign lesion of embryological origin with sellarsuprasellar localization. It is found in 12-33% of normal pituitary glands in autopsy series. Although it is mostly asymptomatic, it can cause symptoms by compressing surrounding neural and pituitary tissues. The most common symptoms are endocrine problems, visual problems and headache. Uncommonly, the lesion can present with apoplexy. It is rarely reported outside sellar-suprasellar sites, such as the cerebellopontine angle, prepontine cistern, and intrasphenoidal locations. We present an intrasphenoidal Rathke’s cleft cyst found during investigation of a headache and operated on. We discussed the case with literature review and two similar reported cases.

scholarly journals Xanthogranulomatous hypophysitis: a rare and often mistaken pituitary lesion

2015 ◽  
Vol 2015 ◽  
Author(s):  
Jaya Sujatha Gopal-Kothandapani ◽  
Veejay Bagga ◽  
Stephen B Wharton ◽  
Daniel J Connolly ◽  
Saurabh Sinha ◽  
...  
Keyword(s):  
Wide Spectrum ◽  
Case Series ◽  
Rathke’S Cleft Cyst ◽  
Rare Form ◽  
Rathke's Cleft Cyst ◽  
Mixed Signal ◽  
Neoplastic Lesion ◽  
T1 And T2 ◽  
Rathke's Cleft ◽  
Signal Intensities

Summary Xanthogranulomatous hypophysitis (XGH) is a very rare form of pituitary hypophysitis that may present both clinically and radiologically as a neoplastic lesion. It may either be primary with an autoimmune aetiology and can occur in isolation or as a part of autoimmune systemic disease or secondary as a reactive degenerative response to an epithelial lesion (e.g. craniopharyngioma (CP), Rathke's cleft cyst, germinoma and pituitary adenomas) or as a part of a multiorgan systemic involvement such as tuberculosis, sarcoidosis or granulomatosis. It may also present with a variation of symptoms in children and adults. Our case series compares the paediatric and adult presentations of XGH and the differential diagnoses considered in one child and two adult patients, highlighting the wide spectrum of this condition. Endocrine investigations suggested panhypopituitarism in all three patients and imaging revealed a suprasellar mass compressing the optic chiasm suggestive of CP or Rathke's cleft cyst in one patient and non-functioning pituitary macroadenoma in two patients. Magnetic resonance imaging (MRI) demonstrated mixed signal intensities on T1- and T2-weighted sequences. Following endoscopic transsphenoidal surgery, histological analysis revealed necrotic material with a xanthogranulomatous reaction confirming XGH in two patients and a necrobiotic granulomatous chronic inflammatory infiltrate with neutrophils in one patient, which is not typical of current descriptions of this disorder. This case series describes the wide spectrum of XGH disease that is yet to be defined. Mixed signal intensities on T1- and T2-weighted MRI sequences may indicate XGH and diagnosis is confirmed by histology. Histological variation may indicate an underlying systemic process. Learning points XGH is a rare form of pituitary hypophysitis with a wide clinical and histological spectrum and can mimic a neoplastic lesion. XGH primarily presents with growth arrest in children and pubertal arrest in adolescents. In adults, the presentation may vary. A combination of hypopituitarism and mixed signal intensity lesion on MRI is suggestive of XGH and should be considered in the differential diagnosis of sellar lesions. Radical surgery is the treatment of choice and carries an excellent prognosis with no recurrence.

An entirely suprasellar Rathke's cleft cyst: case report and review of the literature

2001 ◽  
Vol 8 (6) ◽  
pp. 564-567 ◽  
Author(s):  
Markus Wenger ◽  
Marian Simko ◽  
Regula Markwalder ◽  
Ethan Taub
Keyword(s):  
Case Report ◽  
Rathke’S Cleft Cyst ◽  
Review Of The Literature ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft

scholarly journals Suprasellar Mature Cystic Teratoma Mimicking Rathke’s Cleft Cyst: A Case Report and Systematic Review of the Literature

2021 ◽  
Vol 12 ◽  
Author(s):  
Shenzhong Jiang ◽  
Zhaojian Wang ◽  
Yan You ◽  
Renzhi Wang ◽  
Xinjie Bao
Keyword(s):  
Systematic Review ◽  
Cystic Teratoma ◽  
Mature Cystic Teratoma ◽  
Rathke’S Cleft Cyst ◽  
Review Of The Literature ◽  
Rathke's Cleft Cyst ◽  
Endoscopic Endonasal ◽  
Rathke's Cleft ◽  
Operative Findings

In this article, we present a 31-year-old female who presented with intermittent headache and oligomenorrhea of over 10 years’ duration. Imaging revealed a large suprasellar mass with sellar extension. The patient underwent an endoscopic endonasal trans-sphenoidal surgery to resection of the mass. Clinical, radiological, and operative findings from this patient were initially considered to be Rathke’s cleft cyst (RCC). However, postoperative histological examinations revealed a mature cystic teratoma. No radiotherapy was performed after surgery. At the most recent follow-up, approximately 1 year later, the patient is doing well with no headache and no recurrence of the teratoma.

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