Clinical features, management and recurrence of symptomatic Rathke's cleft cyst

Area of Science:

• Neuroendocrinology
• Neurosurgery
• Pathology

Background:

• Rathke's cleft cysts (RCCs) are uncommon, often asymptomatic, lesions arising from the pituitary gland.
• Understanding their clinical presentation and behavior is crucial for patient management.

Purpose of the Study:

• To characterize the presenting symptoms, endocrinopathy, and recurrence potential of Rathke's cleft cysts.
• To analyze these features within an Australian patient cohort.

Main Methods:

• Retrospective review of 12 patient files with pathologically confirmed Rathke's cleft cysts.
• Analysis of clinical presentations, cyst characteristics, and follow-up imaging.

Main Results:

• Common symptoms included headache, endocrinopathy, and visual disturbances.
• Cyst sizes ranged from 6-20 mm, with 8 having suprasellar extension.
• Recurrence was observed on MRI in 5 out of 12 patients.
• One patient presented with pituitary apoplexy and another with xanthogranulomatous change.

Conclusions:

• Rathke's cleft cysts present with diverse clinical symptoms.
• The observed recurrence rate suggests a potential link to craniopharyngioma, though repeat resection is not always necessary.