Transsphenoidal management of Rathke's cleft cysts a clinicopathological review of 10 cases |
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Authors: | Rajiv Midha M.D. Venita Jay M.D. F.R.C.P. Harley S. Smyth M.D. Ph.D. F.R.C.S. |
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Affiliation: | Departments of Surgery (Neurosurgery) and Pathology (Neuropathology), Wellesley Hospital and University of Toronto, Toronto, Ontario, Canada |
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Abstract: | We report detailed data on 10 patients who underwent transsphenoidal microsurgical management of histopathologically confirmed Rathke's cleft cysts. Preoperatively, pituitary dysfunction was present in 90%, headaches in 80%, hyperprolactinemia in 70%, and visual interference in 40%. Computed tomography and magnetic resonance imaging had 90% and 100% sensitivity, respectively, in disclosing the lesion. The mean follow-up duration was 22 months. There was no mortality. The only morbidity was sustained diabetes insipidus in one case. Resolution or improvement in preoperative dysfunction occurred in the majority of patients: headaches in 100%, visual deficits in 75%, normalization of hyperprolactinemia in 83%, and reversal of panhypopituitarism in 33%. We conclude that Rathke's cleft cysts can be managed safely and effectively with transsphenoidal drainage and partial excision of the wall. |
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Keywords: | Immunohistochemistry Magnetic resonance imaging Pituitary cysts Rathke's cleft cysts Transsphenoidal microsurgery |
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