Endoscopic endonasal transsphenoidal approach for symptomatic Rathke cleft cyst: A case series

Tang,Chao; Wang,Pan; Liu,Jie; Jiang,Haotian; Zhang,Gang; Wu,Nan

doi:10.3892/etm.2022.11649

Endoscopic endonasal transsphenoidal approach for symptomatic Rathke cleft cyst: A case series

Authors:
- Chao Tang
- Pan Wang
- Jie Liu
- Haotian Jiang
- Gang Zhang
- Nan Wu
View Affiliations

Affiliations: Department of Neurosurgery, Chongqing General Hospital, Chongqing 401147, P.R. China
Published online on: October 6, 2022 https://doi.org/10.3892/etm.2022.11649
Article Number: 713
Copyright: © Tang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The purpose of the present study was to evaluate the safety and effectiveness of the surgical method by reviewing the long‑term outcomes of a series of symptomatic Rathke cleft cyst (RCC) cases. The surgical approach was the endoscopic transsphenoidal approach and the surgical strategy was intracapsular decompression, excision of cyst contents, partial excision of the cyst wall and no filling of the cyst cavity. The present study retrospectively analyzed 61 cases of symptomatic RCC treated at Chongqing General Hospital (Chongqing, China) between April 2014 and August 2021, and a detailed evaluation was performed on these cases, including clinical symptoms, imaging features, cyst location and characteristics, intraoperative conditions, postoperative outcomes, postoperative complications and long‑term follow‑up. In the three aspects of clinical symptom relief, postoperative complications and postoperative recurrence rate, this surgical method was analyzed and evaluated. The results suggested that this surgical method is safe and effective for the treatment of symptomatic RCC, which may effectively relieve symptoms and reduce postoperative complications and recurrence.

View Figures

View References

1	Jahangiri A, Potts M, Kunwar S, Blevins L, El-Sayed IH and Aghi MK: Extended endoscopic endonasal approach for suprasellar Rathke's cleft cysts. J Clin Neurosci. 21:779–785. 2014.PubMed/NCBI View Article : Google Scholar
2	Trifanescu R, Ansorge O, Wass JA, Grossman AB and Karavitaki N: Rathke's cleft cysts. Clin Endocrinol (Oxf). 76:151–160. 2012.PubMed/NCBI View Article : Google Scholar
3	Yoshida J, Kobayashi T, Kageyama N and Kanzaki M: Symptomatic Rathke's cleft cyst. Morphological study with light and electron microscopy and tissue culture. J Neurosurg. 47:451–458. 1977.PubMed/NCBI View Article : Google Scholar
4	Amhaz HH, Chamoun RB, Waguespack SG, Shah K and McCutcheon IE: Spontaneous involution of Rathke cleft cysts: Is it rare or just underreported? J Neurosurg. 112:1327–1332. 2010.PubMed/NCBI View Article : Google Scholar
5	el-Mahdy W and Powell M: Transsphenoidal management of 28 symptomatic Rathke's cleft cysts, with special reference to visual and hormonal recovery. Neurosurgery. 42:7–17. 1998.PubMed/NCBI View Article : Google Scholar
6	Benveniste RJ, King WA, Walsh J, Lee JS, Naidich TP and Post KD: Surgery for Rathke cleft cysts: Technical considerations and outcomes. J Neurosurg. 101:577–584. 2004.PubMed/NCBI View Article : Google Scholar
7	Zada G, Lin N, Ojerholm E, Ramkissoon S and Laws ER: Craniopharyngioma and other cystic epithelial lesions of the sellar region: A review of clinical, imaging, and histopathological relationships. Neurosurg Focus. 28(E4)2010.PubMed/NCBI View Article : Google Scholar
8	Barkhoudarian G, Palejwala SK, Ansari S, Eisenberg AA, Huang X, Griffiths CF, Cohan P, Rettinger S, Lavin N and Kelly DF: Rathke's cleft cysts: A 6-year experience of surgery vs observation with comparative volumetric analysis. Pituitary. 22:362–371. 2019.PubMed/NCBI View Article : Google Scholar
9	Zhong W, You C, Jiang S, Huang S, Chen H, Liu J, Zhou P, Liu Y and Cai B: Symptomatic Rathke cleft cyst. J Clin Neurosci. 19:501–508. 2012.PubMed/NCBI View Article : Google Scholar
10	Choi SH, Kwon BJ, Na DG, Kim JH, Han MH and Chang KH: Pituitary adenoma, craniopharyngioma, and Rathke cleft cyst involving both intrasellar and suprasellar regions: Differentiation using MRI. Clin Radiol. 62:453–462. 2007.PubMed/NCBI View Article : Google Scholar
11	Bresson D, Herman P, Polivka M and Froelich S: Sellar lesions/pathology. Otolaryngol Clin North Am. 49:63–93. 2016.PubMed/NCBI View Article : Google Scholar
12	Zacharia BE, Amine M, Anand V and Schwartz TH: Endoscopic endonasal management of craniopharyngioma. Otolaryngol Clin North Am. 49:201–212. 2016.PubMed/NCBI View Article : Google Scholar
13	Nowosielski M, Galldiks N, Iglseder S, Kickingereder P, von Deimling A, Bendszus M, Wick W and Sahm F: Diagnostic challenges in meningioma. Neuro Oncol. 19:1588–1598. 2017.PubMed/NCBI View Article : Google Scholar
14	Culver SA, Grober Y, Ornan DA, Patrie JT, Oldfield EH, Jane JA Jr and Thorner MO: A case for conservative management: Characterizing the natural history of radiographically diagnosed Rathke cleft cysts. J Clin Endocrinol Metab. 100:3943–3948. 2015.PubMed/NCBI View Article : Google Scholar
15	Nishioka H, Haraoka J, Izawa H and Ikeda Y: Headaches associated with Rathke's cleft cyst. Headache. 46:1580–1586. 2006.PubMed/NCBI View Article : Google Scholar
16	Kim JE, Kim JH, Kim OL, Paek SH, Kim DG, Chi JG and Jung HW: Surgical treatment of symptomatic Rathke cleft cysts: Clinical features and results with special attention to recurrence. J Neurosurg. 100:33–40. 2004.PubMed/NCBI View Article : Google Scholar
17	Nishioka H, Haraoka J, Izawa H and Ikeda Y: Magnetic resonance imaging, clinical manifestations, and management of Rathke's cleft cyst. Clin Endocrinol (Oxf). 64:184–188. 2006.PubMed/NCBI View Article : Google Scholar
18	Laws ER and Kanter AS: Rathke cleft cysts. J Neurosurg. 101:571–572. 2004.PubMed/NCBI View Article : Google Scholar
19	Binning MJ, Liu JK, Gannon J, Osborn AG and Couldwell WT: Hemorrhagic and nonhemorrhagic Rathke cleft cysts mimicking pituitary apoplexy. J Neurosurg. 108:3–8. 2008.PubMed/NCBI View Article : Google Scholar
20	Lillehei KO, Widdel L, Astete CA, Wierman ME, Kleinschmidt-DeMasters BK and Kerr JM: Transsphenoidal resection of 82 Rathke cleft cysts: Limited value of alcohol cauterization in reducing recurrence rates. J Neurosurg. 114:310–317. 2011.PubMed/NCBI View Article : Google Scholar
21	Xie T, Hu F, Yu Y, Gu Y, Wang X and Zhang X: Endoscopic endonasal resection of symptomatic Rathke cleft cysts. J Clin Neurosci. 18:760–762. 2011.PubMed/NCBI View Article : Google Scholar
22	Wait SD, Garrett MP, Little AS, Killory BD and White WL: Endocrinopathy, vision, headache, and recurrence after transsphenoidal surgery for Rathke cleft cysts. Neurosurgery. 67:837–843. 2010.PubMed/NCBI View Article : Google Scholar
23	Aho CJ, Liu C, Zelman V, Couldwell WT and Weiss MH: Surgical outcomes in 118 patients with Rathke cleft cysts. J Neurosurg. 102:189–193. 2005.PubMed/NCBI View Article : Google Scholar
24	Fan J, Peng Y, Qi S, Zhang XA, Qiu B and Pan J: Individualized surgical strategies for Rathke cleft cyst based on cyst location. J Neurosurg. 119:1437–1446. 2013.PubMed/NCBI View Article : Google Scholar
25	Cabuk B, Selek A, Emengen A, Anik I, Canturk Z and Ceylan S: Clinicopathologic characteristics and endoscopic surgical outcomes of symptomatic Rathke's cleft cysts. World Neurosurgery. 132:e208–e216. 2019.PubMed/NCBI View Article : Google Scholar
26	Frank G, Sciarretta V, Mazzatenta D, Farneti G, Modugno GC and Pasquini E: Transsphenoidal endoscopic approach in the treatment of Rathke's cleft cyst. Neurosurgery. 56:124–129. 2005.PubMed/NCBI View Article : Google Scholar
27	Chotai S, Liu Y, Pan J and Qi S: Characteristics of Rathke's cleft cyst based on cyst location with a primary focus on recurrence after resection. J Neurosurg. 122:1380–1389. 2015.PubMed/NCBI View Article : Google Scholar
28	Ratha V, Patil S, Karmarkar VS, Shah NJ and Deopujari CE: Surgical management of Rathke cleft cysts. World Neurosurg. 107:276–284. 2017.PubMed/NCBI View Article : Google Scholar
29	Higgins DM, Van Gompel JJ, Nippoldt TB and Meyer FB: Symptomatic Rathke cleft cysts: Extent of resection and surgical complications. Neurosurg Focus. 31(E2)2011.PubMed/NCBI View Article : Google Scholar
30	Koutourousiou M, Grotenhuis A, Kontogeorgos G and Seretis A: Treatment of Rathke's cleft cysts: Experience at a single centre. J Clin Neurosci. 16:900–903. 2009.PubMed/NCBI View Article : Google Scholar
31	Potts MB, Jahangiri A, Lamborn KR, Blevins LS, Kunwar S and Aghi MK: Suprasellar Rathke cleft cysts: Clinical presentation and treatment outcomes. Neurosurgery. 69:1058–1077. 2011.PubMed/NCBI View Article : Google Scholar
32	Kinoshita Y, Tominaga A, Usui S, Arita K, Sakoguchi T, Sugiyama K and Kurisu K: The long-term recurrence of Rathke's cleft cysts as predicted by histology but not by surgical procedure. J Neurosurg. 125:1002–1007. 2016.PubMed/NCBI View Article : Google Scholar
33	Kleinschmidt-DeMasters BK, Lillehei KO and Stears JC: The pathologic, surgical, and MR spectrum of Rathke cleft cysts. Surg Neurol. 44:19–27. 1995.PubMed/NCBI View Article : Google Scholar