Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed.
Eur J Endocrinol
; 165(1): 33-7, 2011 Jul.
Article
en En
| MEDLINE
| ID: mdl-21502327
ABSTRACT
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 ANDMETHODS:
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.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Hipofisarias
/
Quistes del Sistema Nervioso Central
Tipo de estudio:
Etiology_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Eur J Endocrinol
Asunto de la revista:
ENDOCRINOLOGIA
Año:
2011
Tipo del documento:
Article
País de afiliación:
Reino Unido