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The clinical course of Rathke's cleft cysts in pediatric patients: impact on growth and pubertal development

Yousuke Higuchi1,2, Kosei Hasegawa3, Toshihide Kubo2

  • 1Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Clinical Pediatric Endocrinology : Case Reports and Clinical Investigations : Official Journal of the Japanese Society for Pediatric Endocrinology
|January 10, 2022
PubMed

Insights

Rathke's cleft cysts (RCCs) in children can cause growth issues and precocious puberty. Medical treatments, including hormone therapy, are often effective for managing associated endocrinopathy and cyst size.

Area of Science:

  • Pediatric Endocrinology
  • Neurosurgery
  • Radiology

Background:

  • Rathke's cleft cysts (RCCs) are sellar/suprasellar epithelial lesions.
  • While often asymptomatic, RCCs can cause headaches, visual issues, and endocrine disorders.
  • Optimal treatment for RCC-associated endocrinopathy is not well-defined.

Purpose of the Study:

  • To analyze the clinical course, MRI findings, and treatment responses in pediatric patients with RCCs and endocrinopathy.
  • To evaluate the efficacy of medical versus surgical interventions.
  • To identify prevalent endocrine disturbances in this cohort.

Main Methods:

  • Retrospective review of 10 pediatric patients with RCCs and endocrinopathy.
  • Analysis of clinical data, magnetic resonance imaging (MRI) findings, and treatment outcomes.
  • Assessment of hormonal levels and growth parameters.

Main Results:

  • Growth impairment and precocious puberty were common findings.
  • Seven of nine medically treated patients had stable cyst size; two showed reduction.
  • Hormone replacement and gonadotropin suppression therapies were effective.
  • One patient with suprasellar extension underwent surgery.

Conclusions:

  • Medical management, including hormone therapy, is effective for pediatric RCCs with endocrinopathy.
  • Regular imaging and endocrine monitoring are crucial due to potential changes.
  • RCCs can present with diverse endocrine manifestations in children.

Keywords:
GH deficiencyRathke’s cleft cystscentral precocious pubertypituitary imaging

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