Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed.
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 AND METHODS: The records of all patients with RCC seen in the Department of Endocrinology between January 1978 and June 2009 were review...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2011
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| _version_ | 1797065313565540352 |
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| author | Trifanescu, R Stavrinides, V Plaha, P Cudlip, S Byrne, J Ansorge, O Wass, J Karavitaki, N |
| author_facet | Trifanescu, R Stavrinides, V Plaha, P Cudlip, S Byrne, J Ansorge, O Wass, J Karavitaki, N |
| author_sort | Trifanescu, R |
| collection | OXFORD |
| description | 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 AND METHODS: 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. |
| first_indexed | 2024-03-06T21:26:53Z |
| format | Journal article |
| id | oxford-uuid:4367fd2c-292e-442a-ae05-7c956d918e99 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:26:53Z |
| publishDate | 2011 |
| record_format | dspace |
| spelling | oxford-uuid:4367fd2c-292e-442a-ae05-7c956d918e992022-03-26T14:55:07ZOutcome in surgically treated Rathke's cleft cysts: long-term monitoring needed.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4367fd2c-292e-442a-ae05-7c956d918e99EnglishSymplectic Elements at Oxford2011Trifanescu, RStavrinides, VPlaha, PCudlip, SByrne, JAnsorge, OWass, JKaravitaki, N 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 AND METHODS: 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. |
| spellingShingle | Trifanescu, R Stavrinides, V Plaha, P Cudlip, S Byrne, J Ansorge, O Wass, J Karavitaki, N Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed. |
| title | Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed. |
| title_full | Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed. |
| title_fullStr | Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed. |
| title_full_unstemmed | Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed. |
| title_short | Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed. |
| title_sort | outcome in surgically treated rathke s cleft cysts long term monitoring needed |
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