Recurrent Cyst of the Pituitary: 26-Year Follow-Up from First Decompression

Raskind, R; Brown, Howard A.; Mathis, Jacob

doi:10.3171/jns.1968.28.6.0595

Cited by 36 publications

(14 citation statements)

References 10 publications

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“…There has been only one recurrence reported, 24 years after initial drainage. 9 The cyst described by Fagar and Carter, 4 which was similar to ours, has not recurred in 13 years, and, as previously stated, our Cases 1 and 2 are now 6 and 7 years postpartial resection without evidence of recurrence. Therefore, it would appear the prognosis with this type of cyst is equally as good as with the other types.…”

Section: Discussionsupporting

confidence: 83%

“…Fairburn and Larkin 5 described a cyst containing "thick purulent material" which contained a few epithelial cells, but no organisms grew on culture. The reports of Smith and Bucy, 13 and Raskind,et al,9 describe cysts containing clear fluid. Shaw first described a cyst containing colloid material.…”

Section: Discussionmentioning

confidence: 93%

“…3-5,11,~a Some authors have found secretory goblet cells, 1,5 while others have not. 3,9,~3 Raskind, et al, 9 described a single row of epithelial cells which they likened to normal acinar cells. The cysts described in this report had no epithelium lining.…”

Section: Discussionmentioning

confidence: 97%

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Cysts of the sella turcica

El¹,

Fs²,

Gl³

1970

Journal of Neurosurgery

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✓ In three patients intrasellar cysts were found without epithelial lining but containing thick dark brown fluid. The clinical course and histological findings suggested intermittent hemorrhage and infarction of the adenohypophysis as the probable etiology. The surgical importance of differentiating these lesions from cystic craniopharyngiomas and pituitary adenomas has been stressed in a discussion of the diagnostic characteristics. Wide surgical drainage is recommended as the treatment of choice. Evidence points to a possible relationship of these cysts to the “empty sella syndrome.”

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 93%

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Cysts of the sella turcica

El¹,

Fs²,

Gl³

1970

Journal of Neurosurgery

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“…4,~4,z4 Such a course of postoperative care contrasts sharply with that recommended for other cystic sellar lesions. 8,9,23,29,3~ Another notable clinical difference between epidermoid cysts and craniopharyngiomas is that intracranial epi-dermoids tend to present during the third to fifth decades of life, in contrast to the predominance of craniopharyngiomas in the first to second decade. Unfortunately, no detailed comparison of craniopharyngiomas, epidermoid cysts, and other sellar cysts based on clinical or tissue-culture studies has been reported.…”

Section: Discussionmentioning

confidence: 98%

Intrasellar epidermoid cyst

Boggan

Davis

Zorman

et al. 1983

Journal of Neurosurgery

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“…While complete removal or partial resection followed by radiotherapy presents standard treatment of craniopharyngioma, Rathke's cleft cysts may be managed adequately by simple aspiration of the fluid [4,20,21]. However, to avoid recurrence [5,22] evacuation of the cyst and liberal resection of the cyst wall are recommended [23]. Intrasellar cysts with or without suprasellar extension are best approached transsphenoidally while cysts which are mainly suprasellar such as our case usually require a transcranial approach [2].…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Rathke's Cleft Cyst

et al. 1992

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A rare case of symptomatic Rathke's cleft cyst in a 26-year-old female is reported. The clinical and radiological features of this lesion are described with emphasis on the differential diagnosis between Rathke's cleft cyst and craniopharyngioma.Rathke's cleft cysts present a common incidental intrasellar autopsy finding occurring in 13% to 22% of randomly examined pituitary glands [1]. These lesions rarely, however, enlarge sufficiently enough to cause compression of adjacent neural structures. Although to date, approximately 155 cases of symptomatic Rathke's cleft cysts have been reported in the pertinent literature [2]; the condition continues to be largely unknown to clinicians.The purpose of this case report is to draw attention to this pathological entity which should be considered in the differential diagnosis of cystic lesions in the sellar area. To the best of our knowledge, this is the first case of symptomatic Rathke's cleft cyst to be reported from Saudi Arabia. Case ReportThis 26-year-old Filipino female dietitian presented to the Neurosurgical Division of the King Khalid University Hospital with a two month history of constant headaches which were associated with nausea and nonprojectile vomiting. There were no visual disturbances and apart from oligomenorrhea since puberty, her past medical history was unremarkable. ExaminationThe patient was short in stature (height 140 cm and weighed 37.5 kg). Skin and hair distribution were normal. Neurological status of the patient was normal except for a bi-temporal hemianopia.The plain x-ray of the skull revealed erosion of the dorsum sellae with no sellar abnormality. Cranial computerized tomographic (CT) scan showed a large low density lesion measuring 30×39 mm with faint ring enhancement filling the entire suprasellar space with compression of the third ventricle (Figure 1). The magnetic resonance imaging (MRI) demonstrated the lesion extending into the sella and elevating the floor of the third ventricle. The lesion was hyperintense on both T1 and T2 weighted images except for a small nidus which could have represented a solid component of the lesion. The vertebral angiography disclosed marked dorsal displacement of the distal end of the basilar artery.The basal secretion of the following hormones was normal: T3, T4, TSH, Cortisol, prolactin, LH, FSH, and growth hormone. The pituitary dynamic tests after injection of insulin, TRH, and GnRH revealed inadequate GH and FSH responses. OperationThe patient underwent a right frontotemporal craniotomy. A thin-walled, brown-greenish cyst was encountered. The right optic nerve was stretched over the cyst wall and the right carotid artery was displaced laterally. The cyst was punctured and 35 cc of milky greenish fluid was aspirated. The inferior part of the cyst wall was excised leaving the superior part, which was firmly attached to the floor of the third ventricle, unremoved. Postoperative CourseThe patient recovered well but developed transient diabetes insipidus which was controlled with vasopressin. Two year...

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Recurrent Cyst of the Pituitary: 26-Year Follow-Up from First Decompression

Cited by 36 publications

References 10 publications

Cysts of the sella turcica

Cysts of the sella turcica

Intrasellar epidermoid cyst

Symptomatic Rathke's Cleft Cyst

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