Transsphenoidal Endoscopic Approach in the Treatment of Rathke's Cleft Cyst

Neurosurgery ◽  
2005 ◽  
Vol 56 (1) ◽  
pp. 124-129 ◽  
Author(s):  
Giorgio Frank ◽  
Vittorio Sciarretta ◽  
Diego Mazzatenta ◽  
Giovanni Farneti ◽  
Giovanni Carlo Modugno ◽  
...  
Keyword(s):  
Diabetes Insipidus ◽  
Visual Impairment ◽  
Endoscopic Approach ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Invasive Approach ◽  
Pituitary Dysfunction ◽  
Rathke's Cleft Cysts ◽  
Rathke's Cleft

Abstract OBJECTIVE: In this study, the usefulness of the transsphenoidal endoscopic approach in the treatment of a Rathke's cleft cyst is reported. METHODS: Between June 1998 and December 2002, 22 patients affected by sellar-suprasellar Rathke's cleft cysts were treated using a transsphenoidal endoscopic approach. Fourteen patients experienced pituitary dysfunction (64%), five experienced visual impairment (23%), and three reported headaches (14%). RESULTS: The patient follow-up ranged from 8 to 60 months (mean, 33 mo). Pituitary function was restored only in the four patients with hyperprolactinemia, whereas visual impairment and headache improved in all patients. However, when present before surgery, hypopituitarism was unaffected by surgery. Two patients experienced permanent diabetes insipidus (one of them before surgery). Only one recurrence was observed in a 13-year-old girl at 12 months after surgery, and it was treated using a new transsphenoidal endoscopic approach. CONCLUSION: The transsphenoidal endoscopic approach represents a straightforward and mini-invasive approach for the drainage and biopsy of a Rathke's cleft cyst.

scholarly journals Rathke's cleft cyst and partial feet adactyly: an unusual association

2007 ◽  
Vol 65 (4a) ◽  
pp. 1040-1042 ◽  
Author(s):  
Jackson A. Gondim ◽  
Michele Schops ◽  
João Paulo Cavalcante ◽  
Erica Gomes
Keyword(s):  
Neurological Examination ◽  
Brain Mri ◽  
Visual Disturbance ◽  
Endoscopic Approach ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Unusual Association ◽  
Transnasal Endoscopic Approach ◽  
Rathke's Cleft ◽  
The Brain

A 53 year-old woman presented a recurrent bifrontal headache of 2 years duration and bilateral progressive visual disturbance. The clinical and neurological examination showed a bilateral feet adactyly and bitemporal hemianopsia. The brain MRI demonstrated a Rathke's cleft cyst. The patient was operated by a transnasal endoscopic approach. It seems that this unusual association has never been described before.

scholarly journals Endoscopic Transsphenoidal Cisternostomy for Nonneoplastic Sellar Cysts

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Yukai Su ◽  
Yudo Ishii ◽  
Chien-Min Lin ◽  
Shigeyuki Tahara ◽  
Akira Teramoto ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Clinical Presentation ◽  
Arachnoid Cysts ◽  
Invasive Approach ◽  
Csf Fistula ◽  
Pituitary Dysfunction ◽  
Operative Complications ◽  
Rathke's Cleft Cysts ◽  
Fistula Rate ◽  
Rathke's Cleft

Background and Importance. Sellar arachnoid cysts and Rathke’s cleft cysts are benign lesions that produce similar symptoms, including optochiasmatic compression, pituitary dysfunction, and headache. Studies have reported the use of various surgical treatment methods for treating these symptoms, preventing recurrence, and minimizing operative complications. However, the postoperative cerebrospinal fluid (CSF) fistula and recurrence rate remain significant.Clinical Presentation. In this paper, we present 8 consecutive cases involving arachnoid cysts and Rathke’s cleft cysts, which were managed by using drainage and cisternostomy, the intentional fenestration of the cyst into the subarachnoid space, and then meticulously closing sellar floor using dural sutures. The postoperative images, CSF fistula rate, and the recurrence rate were favorable.Conclusion. We report this technique and discuss the benefit of this minimally invasive approach.

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.

scholarly journals Symptomatic Rathke's Cleft Cyst Coexisting with Central Diabetes Insipidus and Hypophysitis: Case Report.

1999 ◽  
Vol 46 (1) ◽  
pp. 187-192 ◽  
Author(s):  
SEIJI HAMA ◽  
KAZUNORI ARITA ◽  
ATSUSHI TOMINAGA ◽  
MASAMI YOSHIKAWA ◽  
KUNIKI EGUCHI ◽  
...  
Keyword(s):  
Case Report ◽  
Diabetes Insipidus ◽  
Central Diabetes Insipidus ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft

scholarly journals A Case of Rathke’s Cleft Cyst Associated with Transient Central Adrenal Insufficiency and Masked Diabetes Insipidus

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Masahiro Asakawa ◽  
Rina Chin ◽  
Yoshihiro Niitsu ◽  
Tetsuo Sekine ◽  
Arisa Niwa ◽  
...  
Keyword(s):  
Diabetes Insipidus ◽  
Adrenal Insufficiency ◽  
Optic Chiasm ◽  
Nasal Administration ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Pituitary Mass ◽  
Silent Thyroiditis ◽  
Central Adrenal Insufficiency ◽  
Rathke's Cleft

A 73-year-old woman admitted to our hospital because of headache, poor appetite, malaise, weight loss, and vomiting was found to have central adrenal insufficiency and thyrotoxicosis due to silent thyroiditis. Polyuria developed after replacement with glucocorticoid (masked diabetes insipidus), which was controlled with nasal administration of desmopressin. Magnetic resonance imaging of the brain showed a large cystic pituitary mass (18 × 18 × 12 mm) extending suprasellarly to the optic chiasm. Transsphenoidal surgery revealed that the pituitary tumor was Rathke’s cleft cyst. Following surgery, replacement with neither glucocorticoid nor desmopressin was needed any more. Therefore, it is suggested that Rathke’s cleft cyst is responsible for the masked diabetes insipidus and the central insufficiency. Furthermore, it is speculated that thyrotoxicosis with painless thyroiditis might induce changes from subclinical adrenal insufficiency to transiently overt insufficiency.

scholarly journals Hypothalamic Type of Hypopituitarism and Central Diabetes Insipidus Probably Linked to Rathke's Cleft Cyst

2015 ◽  
Vol 54 (8) ◽  
pp. 935-940
Author(s):  
Tomoko Asano ◽  
Hodaka Yamada ◽  
Masashi Yoshida ◽  
Atsushi Aoki ◽  
Aki Ikoma ◽  
...  
Keyword(s):  
Diabetes Insipidus ◽  
Central Diabetes Insipidus ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft

Trans-sphenoidal Removal of a Rathke's Cleft Cyst

Neurosurgery ◽  
1979 ◽  
Vol 4 (1) ◽  
pp. 63-65 ◽  
Author(s):  
Lucas J. Martinez ◽  
Jewell L. Osterholm ◽  
Richard G. Berry ◽  
Francis K. Lee ◽  
Norman J. Schatz
Keyword(s):  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Partial Removal ◽  
Rathke's Cleft Cysts ◽  
Radical Removal ◽  
Rathke's Cleft ◽  
Suprasellar Extension ◽  
Visual Disturbances

Abstract Symptomatic Rathke's cleft cysts are uncommon. We present a case with suprasellar extension manifested by hypopituitarism and visual disturbances. The treatment was trans-sphenoidal evacuation and partial removal of the capsule. We suggest that the trans-sphenoidal approach to these lesions is usually adequate and that radical removal of the capsule is not necessary.

scholarly journals Combined Frontotemporal Transbasal Approach for the Resection of a Giant Rathke's Cleft Cyst: Operative Video and Technical Nuances

2018 ◽  
Vol 79 (S 03) ◽  
pp. S276-S277
Author(s):  
James Liu
Keyword(s):  
Rathke’S Cleft Cyst ◽  
Lateral Extension ◽  
Rathke's Cleft Cyst ◽  
Total Resection ◽  
Anterior Clinoid Process ◽  
Skull Base Approach ◽  
Rathke's Cleft Cysts ◽  
Rathke's Cleft ◽  
Neurologically Intact ◽  
Neurovascular Structures

AbstractWe present a case of a giant Rathke's cleft cyst with significant superior extension into the third and right lateral ventricles and lateral extension into the left Sylvian fissure and over the anterior clinoid process. An extended modification of the frontotemporal approach was performed using a combined frontotemporal transbasal approach. This allowed wide exposure to both transsylvian and subfrontal corridors to the retrochiasmatic space. This video atlas demonstrates the operative technique and surgical nuances of the skull base approach, microdissection of the tumor, and safe handling of the neurovascular structures. A gross total resection was achieved and the patient was neurologically intact with improved visual acuity. In summary, the combined frontotemporal transbasal approach is an important strategy in the armamentarium for the surgical management of giant Rathke's cleft cysts.The link to the video can be found at: https://youtu.be/UjhnUZVi03I.

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