Reversible visual deficit following debulking of a Rathke's cleft cyst: a tethered chiasm?

1994 ◽  
Vol 81 (3) ◽  
pp. 459-462 ◽  
Author(s):  
Edwin G. Fischer ◽  
Umberto DeGirolami ◽  
James N. Suojanen
Keyword(s):  
Sella Turcica ◽  
Magnetic Resonance Images ◽  
Empty Sella ◽  
Anatomical Location ◽  
Rathke’S Cleft Cyst ◽  
Optic System ◽  
Rathke's Cleft Cyst ◽  
Anterior Portion ◽  
Content Type ◽  
Rathke's Cleft

✓ Delayed chiasmal syndromes after emptying of a Rathke's cleft cyst have not been reported previously. When these deficits occur following the treatment of parasellar lesions they are usually associated with the descent of a scarred optic system into an empty sella, and vision often improves promptly when the optic system is elevated. Two months after transsphenoidal surgery with emptying of a large intrasellar cyst, a 22-year-old man developed recurrent bitemporal visual field deficits over a 3-day period. Sagittal magnetic resonance images demonstrated an enhancing band of tissue extending anteriorly from the normally placed chiasm down to the anterior portion of the sella turcica. At craniotomy the enhancing tissue was found to be scar extending from the anterior border of the chiasm to the diaphragma sellae. The anterior portion of the diaphragm was resected as widely as possible without dissecting the scar itself from the chiasm. A membrane consistent with the wall of a Rathke's cleft cyst was found attached to the resected tissue. The patient's vision was improved 2 days after surgery. This case illustrates that traction by scar extending from the chiasm to the diaphragm, even when the chiasm is in its normal anatomical location, may cause progressive visual loss; and that untethering of the chiasm by resecting the diaphragm while leaving the scar intact can result in improved vision.

Abscess formation in a Rathke's cleft cyst

1972 ◽  
Vol 36 (3) ◽  
pp. 359-362 ◽  
Author(s):  
Theodore G. Obenchain ◽  
Donald P. Becker
Keyword(s):  
Pituitary Gland ◽  
Replacement Therapy ◽  
Sella Turcica ◽  
Methotrexate Therapy ◽  
Abscess Formation ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Content Type ◽  
Rathke's Cleft ◽  
Fine Print

✓ An abscessed Rathke's cleft cyst was removed in a 50-year-old woman who had had headaches and episodic fever for 3 years and had been on intermittent methotrexate therapy for psoriasis for 4 years. There was clinical and laboratory evidence of panhypopituitarism. Erosion of the sella turcica was present. The patient has remained asymptomatic on replacement therapy. A brief review of abscess formation in the region of the pituitary gland is presented.

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.

The Empty Sella syndrome secondary to Rathke's cleft cyst

1980 ◽  
Vol 53 (1-2) ◽  
pp. 69-78 ◽  
Author(s):  
M. Baldini ◽  
L. Mosca ◽  
L. Princi
Keyword(s):  
Empty Sella ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Empty Sella Syndrome ◽  
Rathke's Cleft

scholarly journals Enlarging pediatric ectopic Rathke’s cleft cyst in the prepontine cistern: case report

2017 ◽  
Vol 20 (5) ◽  
pp. 480-484 ◽  
Author(s):  
Takamasa Kamei ◽  
Masahiro Nonaka ◽  
Yoshiko Uemura ◽  
Yasuo Yamanouchi ◽  
Yumiko Komori ◽  
...  
Keyword(s):  
Cyst Wall ◽  
Histopathological Examination ◽  
Sella Turcica ◽  
Preoperative Imaging ◽  
Rathke’S Cleft Cyst ◽  
Ciliated Cells ◽  
Rathke's Cleft Cyst ◽  
Pediatric Case ◽  
Prepontine Cistern ◽  
Rathke's Cleft

Rathke’s cleft cyst is a cystic disease that occurs in the sella turcica or, occasionally, in the suprasellar area. An ectopic Rathke’s cleft cyst is extremely rare, and its nature is less well understood. The authors report the case of a 14-year-old girl who presented with a growing cystic lesion in the prepontine cistern, immediately behind the dorsum sellae. Preoperative imaging and intraoperative investigation showed part of the cyst wall continuing into the dorsum sellae, to the pituitary gland. The cisternal portion of the cyst wall was totally resected via a right subtemporal approach. Histopathological examination of the cyst wall showed a monolayer of ciliated cells, identical to those of Rathke’s cleft cyst. To the best of the authors’ knowledge, this represents the first pediatric case of Rathke’s cleft cyst occurring in the prepontine cistern.

Magnetic Resonance Imaging of Symptomatic Rathke's Cleft Cyst: Report of a Case

Neurosurgery ◽  
1989 ◽  
Vol 24 (2) ◽  
pp. 276-278 ◽  
Author(s):  
V. G. Wagle ◽  
D. Nelson ◽  
A. Rossi ◽  
D. Uphoff
Keyword(s):  
Pituitary Gland ◽  
Carotid Arteries ◽  
Clinical Evidence ◽  
Sella Turcica ◽  
Optic Chiasm ◽  
Rathke’S Cleft Cyst ◽  
Resonance Imaging ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft ◽  
Optimal Visualization

Abstract A case of symptomatic Rathke's cleft cyst is described. In spite of the intrasellar component and radiological and clinical evidence of involvement of the pituitary gland, the sella turcica was minimally involved. MRI afforded optimal visualization and localization of the intra- and suprasellar components vis-à-vis the pituitary gland, optic chiasm, infundibular stalk, and carotid arteries.

Symptomatic Rathke's cleft cyst

1977 ◽  
Vol 47 (3) ◽  
pp. 451-458 ◽  
Author(s):  
Jun Yoshida ◽  
Tatsuya Kobayashi ◽  
Naoki Kageyama ◽  
Masaki Kanzaki
Keyword(s):  
Electron Microscopy ◽  
Tissue Culture ◽  
Rare Case ◽  
Light And Electron Microscopy ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Content Type ◽  
Rathke's Cleft ◽  
Fine Print

✓ 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.

Symptomatic Rathke's cleft cyst

1976 ◽  
Vol 45 (5) ◽  
pp. 585-588 ◽  
Author(s):  
Howard M. Eisenberg ◽  
Mohammed Sarwar ◽  
Sydney Schochet
Keyword(s):  
Rare Tumor ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Content Type ◽  
Rathke's Cleft ◽  
Fine Print

✓ A case of a symptomatic Rathke's cleft cyst in a 10-year-old boy is described. The importance of the intraoperative differentiation between this rare tumor and a craniopharyngioma is discussed.

Rathke's cleft cyst mimiking pituitary apoplexy: a case report

2018 ◽  
Author(s):  
Ines Barka ◽  
Faiza Bensmaine ◽  
Moctar Bah ◽  
Clara Bouche ◽  
Jean Francois Gautier
Keyword(s):  
Case Report ◽  
Pituitary Apoplexy ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft

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.

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