Intratumoral Rathke's Cleft Cyst Remnants Within Craniopharyngioma, Pituitary Adenoma, Suprasellar Dermoid, and Epidermoid Cysts: A Ubiquitous Signature of Ectodermal Lineage or a Transitional Entity?

Neurosurgery ◽  
2018 ◽  
Vol 85 (2) ◽  
pp. 180-188
Author(s):  
Sunil Manjila ◽  
Nadine El Asmar ◽  
Benjamin M Vidalis ◽  
Fernando Alonso ◽  
Gagandeep Singh ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Dermoid Cyst ◽  
Developmental Theory ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Epidermoid Cysts ◽  
Medical Chart Review ◽  
First Case ◽  
Suprasellar Region ◽  
Rathke's Cleft

Abstract BACKGROUND The authors present cystic epithelial masses in the suprasellar region which on histopathology revealed 4 mixed tumors having simple cuboidal epithelium of Rathke's Cleft Cyst (RCC) elements trapped within pituitary adenoma, epidermoid cyst, dermoid cyst, and papillary craniopharyngioma respectively. OBJECTIVE To highlight the developmental theory of ectodermal continuum in the realm of suprasellar epithelial cystic lesions and examines the cardinal aspects that distinguish RCC from its confounder, ciliary craniopharyngioma. METHODS The authors performed a medical chart review on 4 patients who had coexisting RCC with craniopharyngioma, pituitary adenoma, suprasellar dermoid, and epidermoid cysts. RESULTS This series of unique suprasellar lesions elucidate the spectrum of cases from Rathke's cyst to other suprasellar epithelial cysts including a recently identified clinical entity called ciliary craniopharyngioma, which authors feel is a misnomer. The authors also report the first case of ruptured dermoid cyst admixed with elements of Rathke's cyst elements and xanthogranuloma in neurosurgical literature. CONCLUSION We propose that the new entity of ciliary craniopharyngioma could be just another variant of RCC elements nested within a typical papillary or adamantinomatous lesion. Further study is warranted to understand the implications of natural history with tumors containing RCC elements.

scholarly journals A Pituitary Adenoma Combined with a Rathke's Cleft Cyst : A Case Report

1993 ◽  
Vol 2 (3) ◽  
pp. 238-243 ◽  
Author(s):  
Noriko Takasugi ◽  
Tomotsugu Ichikawa ◽  
Kimihiro Yoshino ◽  
Shunichiro Fujimoto ◽  
Akira Nishimoto ◽  
...  
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft

scholarly journals GH-Producing Pituitary Adenoma and Concomitant Rathke’s Cleft Cyst: A Case Report and Short Review

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ryota Tamura ◽  
Satoshi Takahashi ◽  
Katsura Emoto ◽  
Hideaki Nagashima ◽  
Masahiro Toda ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Sella Turcica ◽  
Short Review ◽  
Pituitary Hormones ◽  
Rathke’S Cleft Cyst ◽  
Resonance Imaging ◽  
Mr Images ◽  
Rathke's Cleft Cyst ◽  
Magnetic Resonance Imaging Mri ◽  
Rathke's Cleft

Concomitant pituitary adenoma (PA) and Rathke’s cleft cyst (RCC) are rare. In some cases, such PA is known to produce pituitary hormones. A 53-year-old man was admitted to our hospital with a diagnosis of lacunar infarction in the left basal ganglia. Magnetic resonance imaging (MRI) incidentally showed a suprasellar mass with radiographic features of RCC. When he consulted with a neurosurgical outpatient clinic, acromegaly was suspected based on his appearance. A diagnosis of growth hormone- (GH-) producing PA was confirmed from hormonal examinations and additional MRI. Retrospectively, initial MR images also showed intrasellar mass that is compatible with the diagnosis of PA other than suprasellar RCC. The patient underwent endonasal-endoscopic removal of the PA. Since we judged that the RCC of the patient was asymptomatic, only the PA was completely removed. The postoperative course of the patient was uneventful and GH levels gradually normalized. Only 40 cases of PA with concomitant RCC have been reported to date, including 13 cases of GH-producing PA. In those 13 cases, RCC tended to be located in the sella turcica, and suprasellar RCC like this case appears rare. In a few cases, concomitant RCCs were fenestrated, but GH levels normalized postoperatively as in the cases without RCC fenestration. If radiographic imaging shows typical RCC, and PA is not obvious at first glance, the possibility of concomitant PA still needs to be considered. In terms of treatment, removal of the RCC is not needed to achieve hormone normalization.

Pituitary Hyposecretion and Hypersecretion Produced by a Rathke's Cleft Cyst Presenting as a Noncystic Hypothalamic Mass

Neurosurgery ◽  
1989 ◽  
Vol 24 (3) ◽  
pp. 424-428 ◽  
Author(s):  
Marc Wenzel ◽  
Michael Salcman ◽  
Donald A. Kristt ◽  
Fouad E. Gellad ◽  
Leonard P. Kapcala
Keyword(s):  
Optic Tract ◽  
Pituitary Hormone ◽  
Pituitary Insufficiency ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Pituitary Dysfunction ◽  
Suprasellar Region ◽  
Rathke's Cleft ◽  
Anterior Pituitary Insufficiency ◽  
Tomography Scan

Abstract A 53-year-old man presented with polydipsia, polyuria, lightheadedness on standing, and syncope. Visual field deficits suggesting left optic tract compression and pituitary dysfunction consisting of diabetes insipidus, hyperprolactinemia, and anterior pituitary insufficiency were diagnosed. On the computed tomography scan, an isodense, ring-enhancing, parasellar mass was localized primarily in the suprasellar region and also extended into the sella. It was believed that the pituitary hormone hypersecretion and hyposecretion were due to hypothalamic dysfunction from the mass which was initially believed to be a craniopharyngioma. At surgery a Rathke's cleft cyst was resected. The unusual presentation of this Rathke's cleft cyst presenting as a hypothalamic lesion is discussed.

Symptomatic Rathke's Cleft Cyst with Pituitary Adenoma: Case Report

Neurosurgery ◽  
1985 ◽  
Vol 17 (4) ◽  
pp. 657-659 ◽  
Author(s):  
Steven E. Swanson ◽  
William F. Chandler ◽  
Joseph Latack ◽  
Katerina Zis
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Operative Treatment ◽  
Rare Case ◽  
Diagnostic Evaluation ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Visual Symptoms ◽  
Rathke's Cleft

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.

Simultaneous Symptomatic Rathke's Cleft Cyst and GH Secreting Pituitary Adenoma: A Case Report

Pituitary ◽  
2004 ◽  
Vol 7 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Lucas J. Bader ◽  
Kawanaa D. Carter ◽  
Richard E. Latchaw ◽  
William G. Ellis ◽  
Jason A. Wexler ◽  
...  
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft

scholarly journals Sellar surprises: a single-centre experience of unusual sellar masses

2020 ◽  
Vol 9 (2) ◽  
pp. 111-121 ◽  
Author(s):  
Kunal Thakkar ◽  
Swati Ramteke-Jadhav ◽  
Rajeev Kasaliwal ◽  
Saba Samad Memon ◽  
Virendra Patil ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Left Internal Carotid Artery ◽  
Nerve Sheath Tumor ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Case Record ◽  
Imaging Characteristics ◽  
Suprasellar Region ◽  
Neoplastic Lesions ◽  
Rathke's Cleft

Background Most common incidentally detected sellar-suprasellar region (SSR) masses are pituitary adenomas, followed by craniopharyngioma, rathke’s cleft cyst, hypophysitis, and meningioma. Besides these, certain unusual SSR lesions can sometimes present as diagnostic challenges, where diagnosis is often made post-operatively on histopathology, the pre-operative suspicion of which might have influenced the management strategies. Series describing such masses are few. Objective To present clinical, biochemical, and radiological characteristics and management outcomes of rare SSR lesions other than pituitary adenomas, craniopharyngioma, rathke’s cleft cyst, hypophysitis, and meningioma. Design, setting, patients Retrospective case record analysis of patients with uncommon SSR masses (from January 2006 to December 2016). Results Our series consisted of ten patients, five with neoplastic and five with non-neoplastic lesions. Neoplastic masses included granular cell tumor (n = 2), astrocytoma (n = 1), malignant peripheral nerve sheath tumor (MPNST, n = 1), and metastasis from occult papillary carcinoma of thyroid (n = 1), while non-neoplastic masses were aspergillus abscess (n = 1), sterile abscess (n = 1), and tubercular abscess (n = 1), aneurysm of left internal carotid artery (n = 1), and ruptured dermoid cyst (n = 1). All patients (except one) presented with headache and/or visual disturbance. Only one patient had acromegaly while most others had hypopituitarism. We describe detailed MRI characteristics of each of the lesion. Seven patients underwent trans-sphenoidal surgery. Post-operatively, five patients had permanent diabetes insipidus, while two patients died in early post-operative period. Conclusion Our series expand the differential diagnostic considerations of SSR lesions. Most of the rare SSR masses present with symptoms of mass effects and hypopituitarism. Except for some non-neoplastic lesions like sellar abscesses, aneurysms, and dermoid cysts which can have some specific imaging characteristics that can provide clue to pre-operative diagnosis, most of the other neoplastic masses have overlapping radiological features, and pre-operative suspicion remains difficult.

scholarly journals A patient with radiological dilemma: hemorrhagic pituitary adenoma or rathke's cleft cyst?

2016 ◽  
Author(s):  
Sevgul Faki ◽  
Oya Topaloglu ◽  
Cuneyt Bilginer ◽  
Neslihan Cuhaci ◽  
Karabekir Ercan ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft
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