Mollaret's meningitis and pituitary failure associated with a Rathke’s cleft cyst

Dancer, Craig; Woods, Marion L.; Henderson, R.D.; Robertson, Thomas; Mungomery, M.; Allworth, Anthony

doi:10.1111/j.1445-5994.2008.01709.x

Cited by 4 publications

(6 citation statements)

References 4 publications

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“…Some RCCs grow progressively over time [1, 3], but few patients with RCCs have obvious clinical symptoms. However, rupture of a RCC may cause severe symptoms [4–7], and RCC is prone to recurrence to a certain extent following surgery [8]. In some patients, RCCs remain stable during long-term followup, whereas some RCCs may undergo reduction after treatment with glucocorticoid [9].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Significance of Intracystic Nodules on MRI in Rathke’s Cleft Cyst

Wang

Xiao²,

Yu³

et al. 2012

International Journal of Endocrinology

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Background and Purpose. To explore strategies for the diagnosis and treatment of Rathke's cleft cyst (RCC). Methods. The medical records of 24 patients with sellar RCC were retrospectively reviewed. Two patients had concomitant pituitary adenoma, 2 underwent transcranial surgery, and 22 underwent transsphenoidal surgery. The clinical features, especially the findings of intracystic nodules on MRI, were evaluated and compared with the pathological findings. Results. Preoperatively, only 2 patients were diagnosed with RCC or suspected RCC. Pre- and postoperative MRI images revealed 10 intracystic nodules in 9 (37.5%) patients. Two nodules had bull's eyelike changes. The signal intensity of the intracystic nodules varied on T1- and T2-weighted images. Not all nodules on T2-weighted images were visualized. Postoperative MRI revealed recurrence or residual lesion in 5 patients; none had new symptoms and a second surgery was not required. Conclusions. Identifying intracystic nodules is important in patients with sellar cystic lesions. Bull's eyelike change in an intracystic nodule on MRI, which is reported here for the first time, potentially might have value for confirming the diagnosis.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Significance of Intracystic Nodules on MRI in Rathke’s Cleft Cyst

Wang

Xiao²,

Yu³

et al. 2012

International Journal of Endocrinology

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“… 12 , 13 Recurrent aseptic meningitis from an RCC is extremely rare, with one prior case reported in the literature. 14 Our patient experienced recurrent aseptic meningitis with the presence of an RCC, without a history of prior neurosurgical intervention. She underwent three LPs, none of which yielded a causative organism, including bacteria, viruses, and fungi.…”

Section: Discussionmentioning

confidence: 79%

Rathke’s cleft cyst presenting with recurrent aseptic meningitis and inflammatory apoplexy: illustrative case

Murayi

Trivedi

Almeida

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND Rathke’s cleft cyst (RCC) is a benign sellar/suprasellar lesion often discovered incidentally. Rarely, symptomatic cases can present with headache and may exhibit concomitant aseptic meningitis or apoplexy. The authors describe a patient with an RCC presenting with recurring episodes of aseptic meningitis and ultimately inflammatory-type apoplexy. OBSERVATIONS A 30-year-old female presented with three episodes of intractable headaches over 2 months. Each episode’s clinical picture was consistent with meningitis though cerebrospinal fluid cultures, and viral tests remained negative. Imaging demonstrated a sellar lesion, initially thought to be coincidental. On the third presentation, there was rapid interval growth of the lesion, adjacent cerebritis, and new endocrinopathy. Resection was then performed via an endoscopic endonasal approach. Pathology showed an RCC with acute and chronic inflammation and no evidence of hemorrhage. Cultures were negative for organisms. The patient received several weeks of antibiotic treatment with the resolution of all symptoms and no recurrence. LESSONS Recurrent aseptic meningitis with apoplexy-like symptoms is a rare presentation of RCC. The authors propose the term inflammatory apoplexy to describe such a presentation without evidence of abscess, necrosis, or hemorrhage. The mechanism is unclear although may be due to intermittent microleakage of cyst contents into the subarachnoid space.

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“…However, virus infection is by no means the only cause. 2,4,6,10 Cases that indicate a relationship between endocrine function and the pathogenesis of benign recurrent aseptic meningitis have rarely been reported. We found only 3 reports in the medical literature.…”

Section: Discussionmentioning

confidence: 99%

“…In many cases, infection with herpes simplex virus, especially herpes simplex virus type 2, was the putative cause, 2,3 whereas in other cases, it seemed to be related to the stimulation of Rathke’s cleft cyst or the use of certain drugs. 4,5 In some cases, the exact cause could not be determined. 6 Few cases indicating a relationship between endocrine disorders and benign recurrent aseptic meningitis have been reported.…”

Section: Introductionmentioning

confidence: 99%

Benign Recurrent Aseptic Meningitis Complicated by Pseudohypoparathyroidism: A Case Report

Xu,

Pu,

Zhao

2023

Clin Pediatr (Phila)

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Mollaret's meningitis and pituitary failure associated with a Rathke’s cleft cyst

Cited by 4 publications

References 4 publications

Diagnostic Significance of Intracystic Nodules on MRI in Rathke’s Cleft Cyst

Diagnostic Significance of Intracystic Nodules on MRI in Rathke’s Cleft Cyst

Rathke’s cleft cyst presenting with recurrent aseptic meningitis and inflammatory apoplexy: illustrative case

Benign Recurrent Aseptic Meningitis Complicated by Pseudohypoparathyroidism: A Case Report

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