Rathke's cleft cyst with pituitary apoplexy: case report

Nishioka, Hiroshi; Ito, Hiroshi; Miki, Takeyoshi; Hashimoto, Takao; Nojima, Hiroki; Matsumura, Hiroyuki

doi:10.1007/s002340050851

Cited by 35 publications

(31 citation statements)

References 11 publications

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“…In our study, the median duration of symptoms was 12 months, ranging between 0.25 and 120 months; this is in accord with previously published data, in which the mean duration of symptoms/signs was 9-24 months (4,12,14,16). Notably, an acute presentation mimicking pituitary apoplexy was found in three of our patients; similar cases have been infrequently described (14,17,18). Headache was the most common clinical feature at presentation (67%), in accord with previously reported studies (55-81%) (4,11,13,14,16,(19)(20)(21)(22)(23).…”

Section: Discussionsupporting

confidence: 92%

Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed

Trifănescu¹,

Stavrinides²,

Plaha³

et al. 2011

European Journal of Endocrinology

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Objective: To clarify the outcome of all cases of Rathke's cleft cysts (RCC) treated surgically and followed up in Oxford during a long-term period. Subjects and methods: The records of all patients with RCC seen in the Department of Endocrinology between January 1978 and June 2009 were reviewed. Results: A total of 33 patients (20 females, median age 43 years) were identified. At presentation, major visual field defects were detected in 58% of patients and gonadotrophin, ACTH and TSH deficiency in 60, 36 and 36% of patients respectively. Desmopressin treatment was required in 18% of patients. Treatment consisted of cyst evacuation combined with or without biopsy/removal of the wall. Post-operatively, visual fields improved in 83% of patients with impairment, whereas there was no reversal of ACTH or TSH deficiency or of diabetes insipidus. All but one subject had imaging follow-up during a mean period of 48 months (range 2-267). Cyst relapse was detected in 22% of patients at a mean interval of 29 months (range 3-48 months); in 57% of them, the recurrence was symptomatic. Relapse-free rates were 88% at 24-months and 52% at 48-months follow-up. At last assessment, at least quadrantanopia was reported in 19% of patients, gonadotrophin, ACTH and TSH deficiency in 50, 42 and 47% of patients respectively. Desmopressin treatment was required in 39% of patients. Conclusions: In this study of patients with RCC and long-term follow-up, we showed a considerable relapse rate necessitating long-term monitoring. Surgical intervention is of major importance for the restoration of visual field defects, but it does not improve endocrine morbidity, which in the long-term affects a substantial number of patients.

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Section: Discussionsupporting

confidence: 92%

Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed

Trifănescu¹,

Stavrinides²,

Plaha³

et al. 2011

European Journal of Endocrinology

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“…The differential diagnosis of a hemorrhagic suprasellar mass includes Rathke cleft cyst [1][2][3][4], craniopharyngioma [5,6], optic or hypothalamic glioma [7][8][9][10][11][12], cavernous angioma [13], venous angioma [14,15], germinoma [16], meningioma [17][18][19], and aneurysm. We describe the first reported case of pituicytoma presenting with spontaneous hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Pituicytoma presenting with spontaneous hemorrhage

2006

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Pituicytomas are rare tumors. Previously reported pituicytomas all presented with signs and symptoms relating to mass effect or endocrinological dysfunction. We report a 47 year old man who presented with sudden, severe headache and was found to have a hemorrhagic suprasellar mass with hemorrhage into the third ventricle. A mass arising from the pituitary stalk was found at surgery, and thorough pathological analysis revealed a pituicytoma. Pituicytoma should be considered in the differential diagnosis of a hemorrhagic suprasellar mass.

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“…Although it tends to be associated with large adenomas, particularly with prolactinomas, it can be associated with any adenomas and, rarely, with nonadenomatous pituitary gland and other lesions [1][2][3]. Despite its uncertain pathogenesis, pathological study has shown that nearly equal numbers have resulted from pure clot, hemorrhagic infarction, and bland infarction [4].…”

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confidence: 99%

Spontaneous Remission of Functioning Pituitary Adenomas without Hypopituitarism following Infarctive Apoplexy: Two Case Reports

2005

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Abstract. Functioning pituitary adenomas may exhibit spontaneous remission after pituitary apoplexy usually in association with hypopituitarism. We report two patients who presented with sudden headache and double vision, showed a ring-enhanced sellar tumor on MRI, underwent transsphenoidal surgery that revealed a coagulation necrotic adenoma without massive hemorrhage, and showed normal pituitary function after the surgery. Definitive diagnoses were made based on immunohistochemistry of the necrotic cells. The findings were consistent with the presence of selective infarct of a GH adenoma and a prolactinoma that had led to remission of acromegaly and menstrual disturbance, respectively, without pituitary insufficiency. In contrast to hemorrhagic apoplexy, infarctive apoplexy tends to affect only the tumor and thus presents with mild symptoms and lack pituitary deficiencies.

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Rathke's cleft cyst with pituitary apoplexy: case report

Cited by 35 publications

References 11 publications

Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed

Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed

Pituicytoma presenting with spontaneous hemorrhage

Spontaneous Remission of Functioning Pituitary Adenomas without Hypopituitarism following Infarctive Apoplexy: Two Case Reports

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