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Clinical Study of Symptomatic Rathke Cleft Cyst Atsushi KEYAKL 1 , Yeong Jing KIM 1 , Sachio NABESHIMA 1 1Department of Neurosurgery, Tenri Hospital Keyword: Rathke cleft cyst , MRI , transsphenoidal surgery , pituitary cyst , sella turcica pp.625-631
Published Date 1999/7/10
DOI https://doi.org/10.11477/mf.1436901748
  • Abstract
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The clinical, radiographic findings in 12 patients with symptomatic Rathke cleft cysts (RCC) are pre-sented. The mean age of these patients was 52 years, and 9 of the patients were female. Visual disturbancewas the most common symptom, followed by headache. Magnetic resonance images (MRIs) were re-viewed in 11 cases. In two cases, the cyst fluid had low signal intensity on Tl-weighted images and highintensity on T2-weighted images. In eight cases the cyst fluid had iso-to-high intensity on both Ti and T2-weighted images. On dynamic MRI study using Gd-DTPA, normal anterior pituitary gland was seen su-perior to the RCC in 4 cases, anterior in 4, and inferior in 2 cases. In accordance with the MRI findings,transcranial approach was chosen in 4 cases and the transsphenoidal route was used in eight cases. Mostsymptoms and signs improved or resolved following surgery with the exception of those cases with a long-standing history of hypopituitarism. We experienced two cases of recurrence at 7 months, and 65 monthsrespectively requiring a second operation, and the mean follow-up period for all cases was 78 months. Dif-ferential diagnosis between RCC and craniopharyngioma should be carefully made in the recurrent casesby surgical specimens of the cyst wall.

Partial resection of the cyst wall and drainage of the contents via the transsphenoiclal route is a safe andeffective procedure in the majority of cases, but the transcranial approach is the treatment of choice incases in which the cyst is entirely located in the suprasellar region.


Copyright © 1999, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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