Rathke's Cleft Cyst or Pituitary Apoplexy: A Case Report and Literature Review

Shatri, Jeton; Ahmetgjekaj, Ilir

doi:10.3889/oamjms.2018.115

Cited by 14 publications

(12 citation statements)

References 17 publications

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“…First, MRI strongly indicated that the intrasellar component of the lesion was etiologically associated with the pituitary gland. Second, the features of the lesion appeared similar to those of RCCs described in human (32–34) and veterinary (31) medicine. In addition, although we performed cytological analysis only after the surgery (which involved removal of the hypophysis), the findings did not exclude a neuroendocrine origin.…”

Section: Discussionsupporting

confidence: 62%

“…Current literature pertaining to veterinary medicine does not document any cases involving such lesions in dogs, although one study has described Rathke's cleft cyst (RCC) secreting antidiuretic hormone in a cat (31). In human medicine, RCCs are benign lesions that arise within the sella, between the anterior and posterior lobes of the pituitary gland, and can compress the surrounding structures of the sella turcica (optic chiasm and pituitary gland); RCCs are incidentally detected in 4–33% human autopsies (32). T2W and T1W images show heterogeneous signal intensity and hyperintensity, respectively.…”

Section: Discussionmentioning

confidence: 99%

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A Recurrent Suprapituitary Ependymal Cyst Managed by Endoscopy-Assisted Transsphenoidal Surgery in a Canine: A Case Report

Lehner

Garamvölgyi

Jakab³

et al. 2019

Front. Vet. Sci.

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A 9-years-old spayed female mixed-breed dog was referred for the evaluation of intermittent head tremors, obtundation, long-standing blindness, and a tendency to seek confined spaces. The dog lost its vision 6 months before the current presentation. A menace response was absent on ophthalmological examination. Neurological examination did not show any abnormalities. A cyst measuring 16 × 18 × 14 mm was observed above the pituitary gland on magnetic resonance imaging. It extended toward the frontal area and compressed the optic chiasm and hypothalamic regions. A minimum preoperative database, including the findings of other required blood tests, was prepared. No abnormal laboratory findings were observed. Endoscopy-assisted transsphenoidal hypophysectomy was performed to remove the pituitary gland, drain the cyst, and partially excise the cyst wall. Normal pituitary gland tissue was observed on histopathology, and the mass was found to have a neuroendocrine or ependymal origin on cytology. Strict post-operative laboratory tests were performed at 1-h intervals for 24 h. An empty sella turcica region, and a collapsed and empty cyst wall was observed on follow-up magnetic resonance imaging. After 3 days of observation, the dog was discharged with a prescription of substitution therapy. However, the dog presented with the same signs and symptoms 73 days after the surgery. Cyst recurrence was apparent on magnetic resonance imaging. The owner requested euthanasia, and an ependymal cyst was observed on necropsy. To the best of our knowledge, we present the first case of an intra- and suprasellar ependymal cyst, and its surgical management in a canine. The findings from this case suggest that endoscopic transsphenoidal drainage and hypophysectomy could be a good surgical approach in cases where involvement of the pituitary gland is confirmed or strongly suspected on the basis of cytological and imaging findings.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

A Recurrent Suprapituitary Ependymal Cyst Managed by Endoscopy-Assisted Transsphenoidal Surgery in a Canine: A Case Report

Lehner

Garamvölgyi

Jakab³

et al. 2019

Front. Vet. Sci.

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“…La alteración de este proceso genera acumulación de secreciones mucoides causando dilatación quística. 6 Los quistes de la hendidura de Rathke por lo regular cursan asintomáticos y se encuentran como hallazgo incidental o bien en autopsias de adultos hasta en un 11-22%. 3 Los que originan síntomas son la minoría y están en relación directa con el tamaño de la lesión y su extensión supraselar, dado que al adquirir un tamaño considerable comprimen las estructuras adyacentes y causan manifestaciones que en los adultos suelen ser cefaleas frontales episódicas presentes en 44-81% de los casos sintomáticos y disfunción hipofisaria encontrada en 30-60% de los pacientes.…”

Section: N T Ro D U C C I ó N D I S C U S I ó N P R E S E N Tac I ó N D E L Ca S Ounclassified

“…9 Otra presentación poco común es la apoplejía pituitaria, la cual se caracteriza por un cuadro clínico consistente en cefalea, cambios en la agudeza visual, vómito, oftalmoplejía y alteración del estado de conciencia. 6 Por último la meningitis aséptica se presenta con signos de irritación meníngea y la punción lumbar revela líquido de características inflamatorias. 7 La resonancia magnética (RM) es la imagen de elección para el diagnóstico siendo superior a la tomografía axial computarizada (TAC), determinando de manera más precisa la extensión del quiste y su relación con la arteria carótida interna y los senos cavernosos, además de una mayor resolución de contraste.…”

Section: N T Ro D U C C I ó N D I S C U S I ó N P R E S E N Tac I ó N D E L Ca S Ounclassified

Quiste de la bolsa de Rathke

2020

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Es una lesión quística que surge como remanente epitelial de la bolsa de Rathke, generalmente su diagnóstico se hace como hallazgo incidental ya que en la mayoría de los casos es asintomático, cuando se presenta de manera sintomática se debe a que ha aumentado lo suficiente su volumen para comprimir estructuras vecinas provocando más frecuentemente cefalea, alteraciones visuales y disfunción pituitaria. El diagnóstico se realiza en su mayoría en adultos entre la cuarta y quinta década de vida, sin embargo presentaremos elcaso de una paciente femenina de 9 años de edad la cual consulta por talla baja al servicio de Endocrinología por lo cual se inicia tratamiento con hormona de crecimiento y se solicita una resonancia magnética nuclear (RMN) la cual reporta Quiste de la bolsa de Rathke versus Adenoma hipofisario.

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“…8,9 Although most are asymptomatic, they can cause mass effect, leading to headaches, pituitary dysfunction, or visual disturbance. 10 Treatment for large or symptomatic cysts almost invariably involves surgical resection to evacuate the cyst and epithelium, typically via a transsphenoidal approach. 11 Small, asymptomatic lesions can be followed radiographically.…”

mentioning

confidence: 99%

Pembrolizumab‐induced hypophysitis with acute progression of Rathke’s cyst

Gamblin

Twitchell

Kundu

et al. 2021

Clinical & Exp Neuroim

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Hypophysitis refers to sellar or suprasellar inflammation that leads to structural changes in the hypothalamic-pituitary axis and varying degrees of pituitary hormonal deficiencies. 1 Hypophysitis is a rare disorder that was first confirmed via magnetic resonance imaging (MRI) in the late 1980s, and the detected incidence has increased dramatically with improvements in imaging quality and understanding of the disease process. Over the past decade, the epidemiological landscape has changed as several newly described forms of hypophysitis have been described, 2 including one caused by immune checkpoint inhibitors (ICIs). Pembrolizumab, an ICI, is a U.S. Food and Drug Administration-approved monoclonal immunoglobulin G4 antibody that induces T-cell-mediated immune responses to various tumors. 3 Pembrolizumab has been established as a rare cause of ICIinduced hypophysitis. [4][5][6] Rathke's cleft cysts (RCCs) are benign lesions first described by Luska in 1860 as "an epithelial area in the capsule of human hypophysis resembling oral mucosa." 7 These benign cysts typically arise within the sella between the lobes of the pituitary. RCCs have been found in 4% to 33% of the population on autopsy. 8,9 Although most are asymptomatic, they can cause mass effect, leading to headaches, pituitary dysfunction, or visual disturbance. 10 Treatment for large or symptomatic cysts almost invariably involves surgical resection to evacuate the cyst and epithelium, typically via a transsphenoidal approach. 11 Small, asymptomatic lesions can be followed radiographically. 12 Despite the relative frequency of RCCs in the population, co-occurrence with ICI-induced hypophysitis has yet to be described.

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Rathke's Cleft Cyst or Pituitary Apoplexy: A Case Report and Literature Review

Cited by 14 publications

References 17 publications

A Recurrent Suprapituitary Ependymal Cyst Managed by Endoscopy-Assisted Transsphenoidal Surgery in a Canine: A Case Report

A Recurrent Suprapituitary Ependymal Cyst Managed by Endoscopy-Assisted Transsphenoidal Surgery in a Canine: A Case Report

Quiste de la bolsa de Rathke

Pembrolizumab‐induced hypophysitis with acute progression of Rathke’s cyst

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