Ophthalmic Manifestations of Rathke's Cleft Cysts

Rao, G. Prasad; Blyth, C.P.J.; Jeffreys, R. V.

doi:10.1016/s0002-9394(14)73818-8

Cited by 21 publications

(15 citation statements)

References 16 publications

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“…In a study of 11 symptomatic patients by Rao et al 5, eight patients initially had visual symptoms. In another study, by Eguchi et al 6, visual symptoms occurred in 47% of patients.…”

Section: Discussionmentioning

confidence: 98%

A case of symptomatic Rathke's cyst

Naik

Thakore

2013

BMJ Case Reports

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Rathke's cleft cyst is a benign growth found on the pituitary gland in the brain, specifically a fluid-filled cyst in the posterior portion of the anterior pituitary gland. It occurs when the Rathke's pouch does not develop properly, and ranges in size from 2 to 40 mm in diameter. Asymptomatic cysts are common, detected during autopsies of 2–26% of individuals who have died of unrelated causes. Symptomatic cysts are rare and only approximately 150 cases have been reported. Females are twice as likely as males to have a cyst. Symptomatic cysts can trigger visual disturbances, pituitary dysfunction and headaches. Here we present a case of a 40-year-old female patient who presented with complains of visual disturbances, headache and amenorrhoea. On investigations, MRI of brain revealed findings suggestive of Rathke's cleft cyst.

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“…In a study of 11 symptomatic patients by Rao et al 5, eight patients initially had visual symptoms. In another study, by Eguchi et al 6, visual symptoms occurred in 47% of patients.…”

Section: Discussionmentioning

confidence: 98%

A case of symptomatic Rathke's cyst

Naik

Thakore

2013

BMJ Case Reports

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“…1,10 Other severe complications include pituitary hemorrhage, apoplexy, and parasellar abscesses. 12,14 Hormonal abnormalities associated with Rathke cleft cysts are usually the result of hyperprolactinemia caused by obstruction of dopamine transport to the anterior pituitary. 9,12 Hyperprolactinemia will cause amenorrhea and galactorrhea in women and decreased libido in men.…”

Section: Discussionmentioning

confidence: 99%

A Symptomatic Prolactinoma Coexisting Within a Rathke Cleft Cyst Invading Bone

Geller¹,

Fan²,

Arteaga³

et al. 2006

The Endocrinologist

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A case of a symptomatic prolactinoma coexisting within a Rathke cleft cyst with bony invasion is presented. A 49-year-old woman presented with headaches, visual changes, and galactorrhea. Magnetic resonance imaging revealed an intrapituitary cystic lesion, and laboratory testing was significant for mildly elevated prolactin. The patient underwent minimally invasive endoscopic surgery, which confirmed the presence of an adherent, cystic mass. Histologic examination of the surgical specimen demonstrated cyst wall and tumor cells invading adjacent bony trabeculae. Immunohistochemical studies were diffusely positive for prolactin. The lesion was determined to be a prolactinoma coexisting with a Rathke cleft cyst with focal bony invasion. The patient had an uneventful postoperative course with prompt resolution of symptoms. Although previous reports have described concomitant pituitary adenomas and Rathke cleft cysts, to our knowledge, this is the first such case with bony invasion. (The Endocrinologist 2006;16: 91-94) Learning Objectives• Outline the demographic, clinical, and endocrinologic abnormalities that occasionally associated with a Rathke cleft cyst and the serious complications that may ensue. • Explain how best to diagnose Rathke cleft cyst and to distinguish between competing mechanisms of associated hyperprolactinemia. • Identify the indications for surgery when a Rathke cleft cyst is suspected, and the surgical approach that is most likely to succeed.

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“…Postoperative period was uneventful and vision 1 week later remained perception of light in the right but improved to 6/60 in the left eye. 2,3 RCCs contain secretion of products from the epithelial cells lining the intermediate lobe. 2,3 RCCs are oft en asymptomatic and discovered incidentally, when radiographic or necropsy 1 (11-33%) fi ndings are reviewed.…”

Section: Case Reportmentioning

confidence: 99%

“…2,3 RCCs contain secretion of products from the epithelial cells lining the intermediate lobe. 2,3 RCCs are oft en asymptomatic and discovered incidentally, when radiographic or necropsy 1 (11-33%) fi ndings are reviewed. These have been reported in various sizes, usually less than 2cm in diameter 4 , the largest being 5 cm.…”

Section: Case Reportmentioning

confidence: 99%

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Rare Case of Severe Visual Compromise Due to a Symptomatic Rathke Cleft Cyst

Saha¹

2014

DJO

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1, an epithelialized rostral invagination of the stomadeum. The Rathke's pouch has an anterior and posterior wall in addition to a central embryonic cleft . The central lumen becomes the Rathke cleft , and normally regresses. 2 However, this structure may persist and enlarge, resulting in the formation of a cyst. RCCs are usually asymptomatic, in rare cases secondary to lesional compression visual disturbances, hypopituitarism, headache and dizziness can occur. 1 We present a patient with bilateral gross visual compromise, due to compression by a RCC; however the pituitary hormonal profi le was surprisingly normal. Case Report50 years old male presented with progressive painless loss of vision in both eyes. One year ago, the patient noticed diminution of vision in the right eye and a month later in the left . He had been initially treated with refractive correction, for a few months. There was no respite in his symptoms, instead loss of vision in both eyes progressed greatly in severity. He did not have any contributory family history or any other co-morbid condition. At presentation, the vision in his right eye was perception of light and in the left eye, counting fi ngers at 2 meters. Pupillary reactions were normal and equivocal bilaterally, however bilateral established papilloedema was seen. Higher mental functions were intact with no cranial nerve defi cits and no sensormotor abnormalities. Perimetry could not be done in the right eye, and in the left eye a temporal defect was found. MRI brain (Figure 1) showed a cystic mass with features of a possible Rathke cleft cyst or craniopharyngioma. Pituitary hormone profi le was unremarkable. By transnasal sphenoidal approach, fl uid was drained from the cyst and marsupilization of the cyst wall was done. Histopathology (Figure 2) showed absence of typical palisading cells, stellate reticulum and calcifi cation, ruling out craniopharyngioma and confi rming Rathke cleft cyst. Postoperative period was uneventful and vision 1 week later remained perception of light in the right but improved to 6/60 in the left eye. Brief Communication

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Ophthalmic Manifestations of Rathke's Cleft Cysts

Cited by 21 publications

References 16 publications

A case of symptomatic Rathke's cyst

A case of symptomatic Rathke's cyst

A Symptomatic Prolactinoma Coexisting Within a Rathke Cleft Cyst Invading Bone

Rare Case of Severe Visual Compromise Due to a Symptomatic Rathke Cleft Cyst

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