Natural history and surgical outcome of Rathke's cleft cysts-A study from the Swedish Pituitary Registry

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Natural history and surgical outcome of Rathke's cleft cysts-A study from the Swedish Pituitary Registry

Petersson, M. (författare): Karolinska Institutet,Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol, SE-17176 Stockholm, Sweden.,Karolinska University Hospital

Berinder, K. (författare): Karolinska Institutet,Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol, SE-17176 Stockholm, Sweden.,Karolinska University Hospital

Ekman, Bertil, 1958- (författare): Linköping University,Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Endokrinmedicinska kliniken,Linköping Univ, Dept Endocrinol Linköping, Linköping, Sweden.;Linköping Univ, Dept Hlth Med & Caring Sci, Linköping, Sweden.

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Tsatsaris, Erika (författare): Uppsala universitet,Endokrinologi och mineralmetabolism,Uppsala University Hospital

Ekman, B. (författare)

Wahlberg, Jeanette, 1969- (författare): Örebro University,Linköping University,Linköpings universitet,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Endocrinology in Linköping and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Internal Medicine, School of Health and Medical Sciences, Örebro University, Örebro, Sweden,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Endokrinmedicinska kliniken,Linköping Univ, Dept Endocrinol Linköping, Linköping, Sweden.;Linköping Univ, Dept Hlth Med & Caring Sci, Linköping, Sweden.;Örebro Univ, Sch Hlth & Med Sci, Dept Internal Med, Örebro, Sweden.

Burman, Pia (författare): Lund University,Lunds universitet,Genomik, diabetes och endokrinologi,Forskargrupper vid Lunds universitet,Genomics, Diabetes and Endocrinology,Lund University Research Groups,Skåne University Hospital

Borg, Henrik (författare): Lund University,Lunds universitet,Genomik, diabetes och endokrinologi,Forskargrupper vid Lunds universitet,Genomics, Diabetes and Endocrinology,Lund University Research Groups,Skåne University Hospital

Siesjö, Peter (författare): Lund University,Lunds universitet,Neurokirurgi,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurosurgery,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital

Dahlqvist, Per (författare): Umeå University,Umeå universitet,Avdelningen för medicin,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden,Umeå Univ, Dept Publ Hlth & Clin Med, Umeå, Sweden.

Akerman, A. K. (författare): Örebro University,Karolinska Institutet,Örebro Univ, Sch Hlth & Med Sci, Dept Internal Med, Örebro, Sweden.

Ragnarsson, Oskar, 1971 (författare): Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Univ Gothenburg, Inst Med Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Gothenburg, Sweden.

Olsson, M. (författare): Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden,Karolinska Univ Hosp, Dept Neurosurg, Stockholm, Sweden.

Forander, P. (författare): Karolinska Institutet,Karolinska Univ Hosp, Dept Neurosurg, Stockholm, Sweden.,Karolinska University Hospital

Bensing, S. (författare): Karolinska Institutet,Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol, SE-17176 Stockholm, Sweden.,Karolinska University Hospital

Hoybye, C. (författare): Karolinska Institutet,Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol, SE-17176 Stockholm, Sweden.,Karolinska University Hospital

Edén Engström, Britt (författare): Uppsala universitet,Endokrinologi och mineralmetabolism,Uppsala University Hospital

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Karolinska Institutet Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden;Karolinska Univ Hosp, Dept Endocrinol, SE-17176 Stockholm, Sweden. (creator_code:org_t)

2021-11
2022
Engelska.
Ingår i: Clinical Endocrinology. - : Wiley. - 0300-0664 .- 1365-2265. ; 96:1, s. 54-61

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

Objective Rathke's cleft cysts are benign, embryological remnants in the pituitary gland. The majority of them are small and asymptomatic but a few may become large, and cause mass effects, pituitary hormone deficiencies and visual impairment. Recommendations for the follow-up of Rathke's cleft cysts vary since data on the natural history are sparse. Patients and Design Data at diagnosis and at 1, 5 and 10 years for patients with a Rathke's cleft cyst (434 at diagnosis, 317 females) were retrieved from the Swedish Pituitary Registry. Cysts <= 3 mm in diameter were excluded from the study. Measurements Data included demographics, cyst size, pituitary function, visual defects and surgery. Results The mean age at diagnosis was 45 years. In patients with cysts <10 mm in diameter (n = 204) 2.9% had pituitary hormone deficiencies and 2% had visual field impairments. Cyst size did not progress during the 5 years. Cysts with a diameter of >= 10 mm that were not operated (n = 174) decreased in size over the years (p < .01). Pituitary hormone deficiencies and visual impairments were more frequent (18% and 5.7%, respectively) but were stable over time. Transphenoidal surgery was performed in 56 patients of whom 51 underwent surgery before the 1-year follow-up. The mean cyst diameter at diagnosis was 18 mm (range: 930 mm), 36% had pituitary hormone deficiency, 45% had visual field defects and 20% had impaired visual acuity. One year after surgery 60% had no cyst remnants, 50% had a pituitary deficiency, 26% had visual field defects and 12% had impaired visual acuity. No major changes were observed after 5 years. Twelve of the operated patients had a follow-up at 10 years, in eight the cyst remnants or recurrences increased in size over time (p < .05). Conclusions Rathke's cleft cysts with a size less than 10 mm rarely grow and our results indicate that radiological follow-up can be restricted to 5 years. In contrast, progression of postoperative remnants or recurrent cysts is more likely and require long-term follow-up.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

cyst size
hypopituitarism
pituitary
Rathke's cleft cyst
transphenoidal surgery
visual impairment
ciliated craniopharyngioma
clinical-features
management
surgery
lesions
Endocrinology & Metabolism
Rathke's cleft cyst

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Av författaren/redakt...: Petersson, M.; Berinder, K.; Ekman, Bertil, 1 ...; Tsatsaris, Erika; Ekman, B.; Wahlberg, Jeanet ...; visa fler...; Burman, Pia; Borg, Henrik; Siesjö, Peter; Dahlqvist, Per; Akerman, A. K.; Ragnarsson, Oska ...; Olsson, M.; Forander, P.; Bensing, S.; Hoybye, C.; Edén Engström, B ...; visa färre...

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