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Endoscopic endonasal removal of an intra-suprasellar Rathke's cleft cyst: case report and surgical considerations.
Minim Invasive Neurosurg. 2002 Mar; 45(1):47-51.MI

Abstract

An endoscopic endonasal approach was performed to remove an intra-suprasellar Rathke's cleft cyst. Rathke's cleft cyst are benign lesions, rarely diagnosed because they are often asymptomatic. To the best of our knowledge, at least 475 cases of Rathke's cleft cysts have been reported. They seem to arise from remnants of Rathke's pouch, an invagination of the stomodeum. A 52-year-old woman, complaining of bilateral frontal headaches, was operated on by using an endoscopic endonasal approach, for an intra-suprasellar tumor. The pre-operative diagnosis was non-functioning pituitary adenoma. Intra-operatively a creamy-coloured viscous tissue was found. After the removal of the cyst contents and of the capsule, the suprasellar structures were seen well. The chiasmatic cistern, the chiasm, the pituitary stalk and the pituitary gland were visualized with 0 and 30 degree endoscopes. The pathological findings showed a well-differentiated cuboidal epithelium. The diagnosis was Rathke's cleft cyst. No post-operative complications were observed. The endoscopic technique was particularly suitable in this case, both for the Rathke's cleft features and for an excellent outcome. The Rathke's cleft cyst was easily removed by suction and the cyst wall was entirely removed with curettes and pituitary punches. The hypophysis was distinguished from the cyst and was preserved. The surgical manoeuvres were all done under direct visual control. The absence of nasal packing and of breathing difficulties made comfortable the post-operative outcome. Thus, the endoscopic endonasal approach can be considered the favourite technique in case of either intra- and/or suprasellar Rathke's cleft cysts.

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Authors+Show Affiliations

Alfieri A
Department of Neurosurgery, A. Manzoni Hospital of Lecco, Italy. alessandralfieri@yahoo.it
Schettino R
No affiliation info available
Tarfani A
No affiliation info available
Bonzi O
No affiliation info available
Rossi GA
No affiliation info available
Monolo L
No affiliation info available

MeSH

Central Nervous System CystsEndoscopyFemaleHumansMagnetic Resonance ImagingMiddle AgedNasal CavityNeurosurgical ProceduresPituitary Gland

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

11932826

Citation

Alfieri, A, et al. "Endoscopic Endonasal Removal of an Intra-suprasellar Rathke's Cleft Cyst: Case Report and Surgical Considerations." Minimally Invasive Neurosurgery : MIN, vol. 45, no. 1, 2002, pp. 47-51.
Alfieri A, Schettino R, Tarfani A, et al. Endoscopic endonasal removal of an intra-suprasellar Rathke's cleft cyst: case report and surgical considerations. Minim Invasive Neurosurg. 2002;45(1):47-51.
Alfieri, A., Schettino, R., Tarfani, A., Bonzi, O., Rossi, G. A., & Monolo, L. (2002). Endoscopic endonasal removal of an intra-suprasellar Rathke's cleft cyst: case report and surgical considerations. Minimally Invasive Neurosurgery : MIN, 45(1), 47-51.
Alfieri A, et al. Endoscopic Endonasal Removal of an Intra-suprasellar Rathke's Cleft Cyst: Case Report and Surgical Considerations. Minim Invasive Neurosurg. 2002;45(1):47-51. PubMed PMID: 11932826.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic endonasal removal of an intra-suprasellar Rathke's cleft cyst: case report and surgical considerations. AU - Alfieri,A, AU - Schettino,R, AU - Tarfani,A, AU - Bonzi,O, AU - Rossi,G A, AU - Monolo,L, PY - 2002/4/5/pubmed PY - 2002/5/25/medline PY - 2002/4/5/entrez SP - 47 EP - 51 JF - Minimally invasive neurosurgery : MIN JO - Minim Invasive Neurosurg VL - 45 IS - 1 N2 - An endoscopic endonasal approach was performed to remove an intra-suprasellar Rathke's cleft cyst. Rathke's cleft cyst are benign lesions, rarely diagnosed because they are often asymptomatic. To the best of our knowledge, at least 475 cases of Rathke's cleft cysts have been reported. They seem to arise from remnants of Rathke's pouch, an invagination of the stomodeum. A 52-year-old woman, complaining of bilateral frontal headaches, was operated on by using an endoscopic endonasal approach, for an intra-suprasellar tumor. The pre-operative diagnosis was non-functioning pituitary adenoma. Intra-operatively a creamy-coloured viscous tissue was found. After the removal of the cyst contents and of the capsule, the suprasellar structures were seen well. The chiasmatic cistern, the chiasm, the pituitary stalk and the pituitary gland were visualized with 0 and 30 degree endoscopes. The pathological findings showed a well-differentiated cuboidal epithelium. The diagnosis was Rathke's cleft cyst. No post-operative complications were observed. The endoscopic technique was particularly suitable in this case, both for the Rathke's cleft features and for an excellent outcome. The Rathke's cleft cyst was easily removed by suction and the cyst wall was entirely removed with curettes and pituitary punches. The hypophysis was distinguished from the cyst and was preserved. The surgical manoeuvres were all done under direct visual control. The absence of nasal packing and of breathing difficulties made comfortable the post-operative outcome. Thus, the endoscopic endonasal approach can be considered the favourite technique in case of either intra- and/or suprasellar Rathke's cleft cysts. SN - 0946-7211 UR - https://www.unboundmedicine.com/medline/citation/11932826/Endoscopic_endonasal_removal_of_an_intra_suprasellar_Rathke's_cleft_cyst:_case_report_and_surgical_considerations_ L2 - https://www.thieme-connect.com/DOI/DOI?10.1055/s-2002-23582 DB - PRIME DP - Unbound Medicine ER -