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Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed.
MedLine Citation:
PMID:  21502327     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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 1/1978-6/2009 were reviewed. Results: Thirty-three patients (20 females, median age 43 years) were identified. At presentation, major visual filed defects were detected in 58% and gonadotrophin, ACTH and TSH deficiency in 60%, 36% and 36%, respectively; Desmopressin treatment was required in 18%. Treatment consisted of cyst evacuation combined or not with biopsy/removal of the wall. Post-operatively, visual fields improved in 83% of those 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% 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%, gonadotrophin, ACTH and TSH deficiency in 50%, 42% and 47%, respectively; Desmopressin treatment was required in 39%. Conclusions: In this series 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.
Authors:
Raluca Trifanescu; Vassilis Stavrinides; Puneet Plaha; Simon Cudlip; James V Byrne; Olaf Ansorge; John Ah Wass; Niki Karavitaki
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-18
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  -     ISSN:  1479-683X     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
R Trifanescu, Department of Endocrinology, Churchill Hospital, Oxford Centre for Diabetes, Endocrinology and metabolism, Oxford, United Kingdom.
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