Abstract #1000674: A Rare Case Of Hemorrhagic Rathke’s Cleft Cyst Presenting With Severe Hyponatremia

2021 ◽  
Vol 27 (6) ◽  
pp. S114-S115
Author(s):  
Peggy N. Amoakohene ◽  
Gregory Hong
Neurosurgery ◽  
1985 ◽  
Vol 17 (4) ◽  
pp. 657-659 ◽  
Author(s):  
Steven E. Swanson ◽  
William F. Chandler ◽  
Joseph Latack ◽  
Katerina Zis

Abstract A rare case of a pituitary adenoma found in association with a symptomatic Rathke's cleft cyst in a 34-year-old woman presenting with headaches, visual symptoms, and amenorrhea is described. The diagnostic evaluation and operative treatment of these coincident lesions are discussed.


Author(s):  
Amalina Che Din ◽  
Celine Fong ◽  
Chon Sum Ong

The occurrence of symptomatic Rathke's cleft cyst (RCC) apoplexy is extremely rare. This is often misdiagnosed due to similar presentations to subarachnoid haemorrhage and pituitary apoplexy. This case highlights an excellent example of similar clinical presentation and serves as a learning case for clinicians. A 40-year-old lady presented to a district hospital with 9 days of worsening severe headache associated with blurring of vision, photophobia, stiff neck, nausea and vomiting. Nuchal rigidity and Brudzinski’s positive. Blood test showed hyponatremia, raised inflammatory markers and normal dynamic pituitary function test. CT Head demonstrated no evidence of space-occupying lesion or intracranial haemorrhage. Lumbar puncture showed xanthochromia positive consistent with subarachnoid haemorrhage. MRI head advised by Neurosurgery team and revealed a focal lesion involving anterior pituitary macroadenoma with mass effect on optic chiasm with possible haemorrhage within. Further assessment in tertiary hospital confirmed loss of visual acuity and field deficit. Patient underwent emergency endoscopic transnasal transsphenoidal resection of apoplectic tumour and repair of CSF leak with graft from thigh. Histopathology report showed a Rathke’s cleft cyst with squamous metaplasia. Post operatively, the patient developed sinusitis which fully recovered, and MRI showed good decompression. The author demonstrated a rare case of symptomatic RCC which was initially presumed to be pituitary apoplexy. Radiology imaging and treatment approach for both conditions are quite similar and can only be differentiated by histopathology. Further research is required to identify the causes and risk factors of RCC apoplexy to aid early detection and diagnosis.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S23


2014 ◽  
Vol 16 (12) ◽  
pp. 1010-1015 ◽  
Author(s):  
Stefanie M DeMonaco ◽  
Michael W Koch ◽  
Teresa L Southard

An 11-year-old spayed female domestic shorthair cat was evaluated for anorexia, lethargy and weight loss of 6 days’ duration. Bilateral mydriasis, absent menace response, slow-to-absent pupillary light reflexes, bilateral retinal detachment, intermittent horizontal nystagmus, intermittent ventral strabismus and systemic hypertension were present. Biochemical analysis revealed severe hyponatremia, severe hypochloremia and mild hypokalemia. Multifocal central nervous system disease was suspected based on optic, trigeminal sensory (ophthalmic branch), vestibulocochlear and possible oculomotor nerve dysfunction. Thoracic radiographs showed mild cardiomegaly without evidence of congestive heart failure. Ultrasound revealed mild pleural and peritoneal effusion. A cause of the severe hyponatremia was not identified, and it persisted despite fluid therapy. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) was suspected as the cause of hyponatremia. Humane euthanasia was elected owing to continued clinical decline. Serum hyposmolality, urine hyperosmolality, natriuresis and lack of confirmed renal, thyroid and pulmonary disease aided in the presumed diagnosis of SIADH. Post-mortem histopathology of the brain revealed degeneration of the hypothalamus and optic tracts, along with a prominent fluid-filled craniopharyngeal duct (putative Rathke’s cleft cyst) separating the pars distalis and the pars intermedius. The hypothalamic degeneration, possibly secondary to a Rathke’s cleft cyst, was hypothesized to be the cause of presumptive SIADH in the patient. Although rare in occurrence, Rathke’s cleft cyst should be included as a differential diagnosis in dogs and cats with signs of pituitary dysfunction.


1977 ◽  
Vol 47 (3) ◽  
pp. 451-458 ◽  
Author(s):  
Jun Yoshida ◽  
Tatsuya Kobayashi ◽  
Naoki Kageyama ◽  
Masaki Kanzaki

✓ A rare case is reported in which a symptomatic Rathke's cleft cyst was studied by light and electron microscopy and tissue culture. The findings are compared with those of a craniopharyngioma studied in the same way. The patient was a 26-year-old woman presenting with headache, chiasmatic syndrome, and hypopituitarism. A cyst containing a mural nodule was partially removed and an Ommaya reservoir placed in the operative site for further treatment. The cyst wall was composed of connective tissue and three kinds of epithelial cells: non-ciliated squamous, ciliated columnar, and mucous-secreting cells. The morphology of these cells in vitro was similar to prickle cells seen in craniopharyngioma and the epidermis. It is concluded that both Rathke's left cyst and craniopharyngioma originate in remnants of Rathke's pouch, but at times may show some histological differences.


2018 ◽  
Author(s):  
Ines Barka ◽  
Faiza Bensmaine ◽  
Moctar Bah ◽  
Clara Bouche ◽  
Jean Francois Gautier

Pituitary ◽  
2021 ◽  
Author(s):  
F. Aranda ◽  
R. García ◽  
F. J. Guarda ◽  
F. Nilo ◽  
J. P. Cruz ◽  
...  

Author(s):  
Rebecca Limb ◽  
James King

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.


1999 ◽  
Vol 141 (10) ◽  
pp. 1055-1061 ◽  
Author(s):  
N. Saeki ◽  
K. Sunami ◽  
Y. Sugaya ◽  
A. Yamaura

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