Background Rathke＇s cleft cyst （RCC） is one of the most common incidentally discovered sellar lesions, while symptomatic cases are relatively rare. Surgical treatment is recommended for symptomatic patients to drai...Background Rathke＇s cleft cyst （RCC） is one of the most common incidentally discovered sellar lesions, while symptomatic cases are relatively rare. Surgical treatment is recommended for symptomatic patients to drain the cyst content and to remove the capsule safely. The aim of this study was to clarify the clinical features, surgery considerations and therapy outcomes of symptomatic RCCs. Methods Totally 42 patients （19 males and 23 females） were retrospectively reviewed with the diagnosis of RCCs under surgery resection at the Affiliated Hospital of Medical College, Qingdao University between January 2005 and December 2010. Results Patients＇ age ranged from 6 to 67 years （mean of 41.6 years）. The duration of symptoms ranged from 4 days to 10 years. Headache （69%）, visual impairment （36%）, and pituitary dysfunction （10%） were the most common presenting symptoms. The maximum diameter of cysts ranged from 6.0 to 46.7 mm （mean of 20.07 mm）. Of the 42 patients, 36 underwent endonasal transsphenoidal approach and the others underwent transcranial approach. Thirty patients had a subtotal resection and decompression, while 12 patients had a total cyst resection. Cysts of 28 patients were lined by simple cubical or columnar epithelium, and cysts of 34 patients were filled by amorphous colloid material, that was the characteristic of RCCs. The majority of patients presented with a simple headache, and 93% of this group experienced a complete improvement after surgery. Twelve of 15 patients （80%） with preoperative visual deficits experienced an improvement in their vision after surgery. All of those patients with pituitary dysfunction experienced an improved endocrine status. The endocrinological complication usually was diabetes insipidus, and postoperative transient diabetes insipidus occurred in 13 （31%） patients without any permanent diabetes insipidus. The overall recurrence rate was 7% at a mean follow-up of 22 months （range 12-60 months）. Conclusions Surgical treatment is to drain the contents of the cyst and to remove the capsule as much as possible under the precondition that does not increase the complications. Biopsy and decompression procedures are recommended for most cases.展开更多
It has not been reported that Turner syndromecould be associated with Rathke cleft cyst yet,nowwe report such a case found in our hospital.Clinical data:The patient,social sex female,15.3ys,was a junior high school st...It has not been reported that Turner syndromecould be associated with Rathke cleft cyst yet,nowwe report such a case found in our hospital.Clinical data:The patient,social sex female,15.3ys,was a junior high school student.Chief com-plaints:She had short stature for 10^+ years and no pu-berche.She was a first full term fetus with cephalicpresentation.The delivery was accomplished by episi-otomy and vacuum extracter with a history of展开更多
Rathke cleft cysts are benign sellar lesions that are generally asymptomatic. Rathke cleft cyst can enlarge and become symptomatic. Surgical therapy is the mainstay of treatment for symptomatic RCC. The optimal surgic...Rathke cleft cysts are benign sellar lesions that are generally asymptomatic. Rathke cleft cyst can enlarge and become symptomatic. Surgical therapy is the mainstay of treatment for symptomatic RCC. The optimal surgical strategy remains debatable. We report our experience with this lesion and we discuss the advantages and disadvantages of each technique through a literature review.展开更多
Rathke cleft cyst is thought to arise from incomplete obliteration of the lumen of Rathke pouch. The cells of the anterior pituitary lobe, from which pituitary adenomas develop, are also derived from the cells of Rath...Rathke cleft cyst is thought to arise from incomplete obliteration of the lumen of Rathke pouch. The cells of the anterior pituitary lobe, from which pituitary adenomas develop, are also derived from the cells of Rathke pouch. Although Rathke cleft cyst and pituitary adenoma have a shared ancestry, they rarely occur coincidentally. Rathke cleft cysts have been found incidentally in 11% - 33% of post-mortem examinations, and were associated with 1.7% - 2.1% of the pituitary adenoma cases. These coexisting lesions are difficult to diagnose pre-operatively due to the variable signal intensity and position of the Rathke cleft cysts. Treatment of these lesions involves surgical resection to decrease mass effect and medical management to normalize hormonal imbalances. To our best knowledge, only 42 cases of Rathke cleft cyst with a coexisting pituitary adenoma have been reported in the English or Japanese literatures, but none of the coexisting pituitary adenoma is gonadotropin producing. We would like to report a case of Rathke cleft cyst with a coexisting gonadotropin producing adenoma that was successfully treated by endoscopic endonasal transsphenoidal approach with the removal of the sellar lesion and temporary hormone replacement.展开更多
目的探讨垂体Rathke＇s囊肿物理性状与患者症状和预后的关系。方法回顾性分析2005年4月至2013年5月手术治疗的104例垂体Rathke＇s囊肿患者的临床资料,其中87例病人术后随访5~92个月,平均26.6个月。结果本组囊肿直径为8~30 mm,平均（15.3...目的探讨垂体Rathke＇s囊肿物理性状与患者症状和预后的关系。方法回顾性分析2005年4月至2013年5月手术治疗的104例垂体Rathke＇s囊肿患者的临床资料,其中87例病人术后随访5~92个月,平均26.6个月。结果本组囊肿直径为8~30 mm,平均（15.3±5.0）mm,其中〈10 mm 7例,10~20 mm 69例,≥20 mm 28例。囊液含结晶54例,无结晶50例;囊液清亮37例,囊液粘稠67例。术后3个月复查MRI示囊肿全切除85例,囊肿残留2例;全切率为97.7%。术后复发3例,复发率为3.4%。头晕患者囊液含结晶的比例明显高于无头晕的患者（P〈0.05）;垂体激素水平异常的患者囊液含结晶的比例明显高于垂激素正常的患者（P〈0.05）;视力减退患者囊肿直径明显大于无视力减退者（P〈0.01）。结论垂体Rathke＇s囊肿囊内少量结晶与头晕有关,而大量结晶与垂体激素水平异常有关。手术治疗Rathke＇s囊肿的效果良好,术后并发症少,复发率低;术中处理好囊肿的分隔及囊内结晶是避免Rathke＇s囊肿残留与复发的关键。展开更多
文摘Background Rathke＇s cleft cyst （RCC） is one of the most common incidentally discovered sellar lesions, while symptomatic cases are relatively rare. Surgical treatment is recommended for symptomatic patients to drain the cyst content and to remove the capsule safely. The aim of this study was to clarify the clinical features, surgery considerations and therapy outcomes of symptomatic RCCs. Methods Totally 42 patients （19 males and 23 females） were retrospectively reviewed with the diagnosis of RCCs under surgery resection at the Affiliated Hospital of Medical College, Qingdao University between January 2005 and December 2010. Results Patients＇ age ranged from 6 to 67 years （mean of 41.6 years）. The duration of symptoms ranged from 4 days to 10 years. Headache （69%）, visual impairment （36%）, and pituitary dysfunction （10%） were the most common presenting symptoms. The maximum diameter of cysts ranged from 6.0 to 46.7 mm （mean of 20.07 mm）. Of the 42 patients, 36 underwent endonasal transsphenoidal approach and the others underwent transcranial approach. Thirty patients had a subtotal resection and decompression, while 12 patients had a total cyst resection. Cysts of 28 patients were lined by simple cubical or columnar epithelium, and cysts of 34 patients were filled by amorphous colloid material, that was the characteristic of RCCs. The majority of patients presented with a simple headache, and 93% of this group experienced a complete improvement after surgery. Twelve of 15 patients （80%） with preoperative visual deficits experienced an improvement in their vision after surgery. All of those patients with pituitary dysfunction experienced an improved endocrine status. The endocrinological complication usually was diabetes insipidus, and postoperative transient diabetes insipidus occurred in 13 （31%） patients without any permanent diabetes insipidus. The overall recurrence rate was 7% at a mean follow-up of 22 months （range 12-60 months）. Conclusions Surgical treatment is to drain the contents of the cyst and to remove the capsule as much as possible under the precondition that does not increase the complications. Biopsy and decompression procedures are recommended for most cases.
文摘It has not been reported that Turner syndromecould be associated with Rathke cleft cyst yet,nowwe report such a case found in our hospital.Clinical data:The patient,social sex female,15.3ys,was a junior high school student.Chief com-plaints:She had short stature for 10^+ years and no pu-berche.She was a first full term fetus with cephalicpresentation.The delivery was accomplished by episi-otomy and vacuum extracter with a history of
文摘Rathke cleft cysts are benign sellar lesions that are generally asymptomatic. Rathke cleft cyst can enlarge and become symptomatic. Surgical therapy is the mainstay of treatment for symptomatic RCC. The optimal surgical strategy remains debatable. We report our experience with this lesion and we discuss the advantages and disadvantages of each technique through a literature review.
文摘Rathke cleft cyst is thought to arise from incomplete obliteration of the lumen of Rathke pouch. The cells of the anterior pituitary lobe, from which pituitary adenomas develop, are also derived from the cells of Rathke pouch. Although Rathke cleft cyst and pituitary adenoma have a shared ancestry, they rarely occur coincidentally. Rathke cleft cysts have been found incidentally in 11% - 33% of post-mortem examinations, and were associated with 1.7% - 2.1% of the pituitary adenoma cases. These coexisting lesions are difficult to diagnose pre-operatively due to the variable signal intensity and position of the Rathke cleft cysts. Treatment of these lesions involves surgical resection to decrease mass effect and medical management to normalize hormonal imbalances. To our best knowledge, only 42 cases of Rathke cleft cyst with a coexisting pituitary adenoma have been reported in the English or Japanese literatures, but none of the coexisting pituitary adenoma is gonadotropin producing. We would like to report a case of Rathke cleft cyst with a coexisting gonadotropin producing adenoma that was successfully treated by endoscopic endonasal transsphenoidal approach with the removal of the sellar lesion and temporary hormone replacement.
文摘目的探讨垂体Rathke＇s囊肿物理性状与患者症状和预后的关系。方法回顾性分析2005年4月至2013年5月手术治疗的104例垂体Rathke＇s囊肿患者的临床资料,其中87例病人术后随访5~92个月,平均26.6个月。结果本组囊肿直径为8~30 mm,平均（15.3±5.0）mm,其中〈10 mm 7例,10~20 mm 69例,≥20 mm 28例。囊液含结晶54例,无结晶50例;囊液清亮37例,囊液粘稠67例。术后3个月复查MRI示囊肿全切除85例,囊肿残留2例;全切率为97.7%。术后复发3例,复发率为3.4%。头晕患者囊液含结晶的比例明显高于无头晕的患者（P〈0.05）;垂体激素水平异常的患者囊液含结晶的比例明显高于垂激素正常的患者（P〈0.05）;视力减退患者囊肿直径明显大于无视力减退者（P〈0.01）。结论垂体Rathke＇s囊肿囊内少量结晶与头晕有关,而大量结晶与垂体激素水平异常有关。手术治疗Rathke＇s囊肿的效果良好,术后并发症少,复发率低;术中处理好囊肿的分隔及囊内结晶是避免Rathke＇s囊肿残留与复发的关键。
