Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed

R Trifanescu, V Stavrinides, P Plaha, S Cudlip, J V Byrne, O Ansorge, J A H Wass, N Karavitaki

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21 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)33-7
Number of pages5
JournalEuropean Journal of Endocrinology
Issue number1
Publication statusPublished - Jul 2011


  • Adenoma
  • Adolescent
  • Adrenocorticotropic Hormone
  • Adult
  • Aged
  • Aged, 80 and over
  • Central Nervous System Cysts
  • Child
  • Deamino Arginine Vasopressin
  • Diabetes Insipidus
  • Female
  • Follicle Stimulating Hormone
  • Humans
  • Luteinizing Hormone
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Pituitary Neoplasms
  • Thyrotropin
  • Treatment Outcome
  • Visual Fields


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