Clinical Characteristics,Treatment And Outcomes Of Rathke’s Cleft Cysts

Objective:With the development of the MRI technology,more and more patrients with Rathke’s cleft cysts are found.However,the large patients’ data are needed to identify the natural history,strategies of treatment and outcomesMethodA retrospective review of records and data from 85 patients,who were diagnosed with Rathke’s cleft cysts from January 1,2010 to December 31,2018,was performed.It was analyzed including the main complain,pituitary function,treatment,imaging findings,operational strategies,complications as well as follow up.·Data are analysis by Chi-square test and Mann-Whitney U test.Results:1.Of the 85 patients diagnosed with Rathke’s cleft cysts,50(58.8%)patients are females and 35 patients are males.The age of the patients is 41.8±20.1.2.The main complaint’are headaches(48%),vision disturbance(30%),pituitary hormone abnormalities(one axe,16.5%)as well as more axes(3.5%)and no symptom(1 case).3.Pituitary hormones test indicates 19 cases linking to FT4 abnormal and 23 cases disturbance in Cortisol.In contrast,only 4 cases witness the abnormal in hGH.4.As for the site of the cysts,cysts in suprasellar are 11 cases,both in suprasellar and intrasellar are 37 cases and that in intrasellar are 17 cases.5.Totally 42 operational patients,36 cases undergo transnasal-sphenoidal microsurgery,in which 30 cases are assistance of neuroendoscopy.In addition,6 patients are done by craniotomy.6.During the operation,the features and contents of cysts are mucoid(16 cases),gelatin(19 cases)and CSF-like liquid(5 cases).The color of’the cysts is grey(14 cases),yellow(13 cases),red(3 cases),blue(3 cases)and so on.7.The complication of operation is CSF leak(2 cases),inf’ection(3 cases)and transient disturbance of water electrolyte and hormones.8.The long term outcome shows that weight change could be witnessed in 25 patients,those who are body-type obesity(10 cases),abdomen obesity(7 cases)and peripheral obesity(8 cases).9.The symptom of headache is associated with body weight,hypothyroidism,cavernous sinus compression and size of cysts.conclusion:Rathke’s cleft cysts cause the symptoms besides visual field disturbances and headaches,which could be improvement or resolution by the operation.An endonasal endoscopic transsphenoidal approach is suggested to treat the disease.And long-term fellow up indicates the change of the hormones,leading the relocated of the fat.