Rathke’s cleft cyst infections and pituitary abscesses: case series and review of the literature

Aranda, Francisco; García, Raquel; Guarda, Francisco J; Nilo, Flavia; Cruz, Juan Pablo; Callejas, Claudio; Balcells, María Elvira; González, Gilberto; Rojas, Ricardo

doi:10.1007/s11102-020-01115-2

Cited by 12 publications

(51 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Whereas, in patients where the deficiency had been present prior to developing the abscess, none of those patients had recovery of their hormone deficiency. [4][5][6][7][8] In our patient, following surgery and antibiotic therapy, her new onset secondary adrenal insufficiency, which presumably started within the last 6 months coinciding with worsening of her chronic headaches and new weight loss, resolved. However, her pre-existing secondary hypothyroidism and amenorrhea diagnosed 3 years prior to presentation persisted.…”

Section: Case Reportmentioning

confidence: 50%

“…In up to 60% of cases, no pathogen could be identified, which can occur if there is preoperative antibiotic therapy or inadequate collection technique. [2][3][4][5][6][7][8] In our case, the patient had a known history of a pituitary lesion, which is a risk factor for developing abscess. In this patient, the culture grew S. epidermidis, although there was concern for potential uncultured organisms.…”

Section: Discussionmentioning

confidence: 92%

“…However, 70% of cases occur de novo in a normal pituitary gland. [2][3][4][5][6][7][8] Abscesses can arise either by haematogenous seeding of the pituitary gland or by extension from an adjacent infection, such as meningitis, sphenoid sinusitis, thrombophlebitis or contaminated cerebrospinal fluid (CSF) fistula. 4 6 7 Causative organisms described in causing pituitary abscesses represent a wide spectrum of pathogens.…”

Section: Discussionmentioning

confidence: 99%

“…The most common presenting complaint was headache (69%-100%), followed by anterior pituitary dysfunction (54%-84%) and visual disturbances (27.3%-100%). [2][3][4][5][6][7][8] Unfortunately, these symptoms are non-specific for pituitary abscess and can be seen with pituitary lesions. Diabetes insipidus is reported in 41%-70% of cases, which is a less common endocrinopathy to occur preoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…The proper clinical context should be applied, as similar characteristics can be seen with other sellar lesions, such as craniopharyngiomas and Rathke's cleft cysts. [1][2][3][4][5][6][7][8] Assessing the apparent diffusion coefficient on imaging might be helpful, as abscesses will have a reduction in the apparent diffusion coefficient, whereas necrotic tumours will have higher values. 9 The mainstay of therapy is trans-sphenoidal surgical excision, followed by antibiotic therapy for 4-6 weeks.…”

Section: Case Reportmentioning

confidence: 99%

See 4 more Smart Citations

Case of an atypical pituitary abscess

et al. 2021

View full text Add to dashboard Cite

A pituitary abscess is a rare intrasellar infection. Correct identification can be challenging preoperatively given its non-specific symptoms and imaging findings. We report a case of a young woman presenting with secondary amenorrhea, visual field deficits and a 2.6 cm pituitary lesion diagnosed to be a craniopharyngioma. A concomitant unexpected pituitary abscess was diagnosed intraoperatively without associated meningeal symptoms.

show abstract

Section: Case Reportmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

See 3 more Smart Citations

Case of an atypical pituitary abscess

et al. 2021

View full text Add to dashboard Cite

show abstract

Pituitary Abnormalities

Liu

2023

Incidental Findings of the Nervous System

View full text Add to dashboard Cite

Comparison of clinical and radiological characteristics of inflammatory and non-inflammatory Rathke cleft cysts

Matsushita,

Shimono,

Maeda

et al. 2024

Jpn J Radiol

View full text Add to dashboard Cite

Purpose Rathke cleft cysts are commonly encountered sellar lesions, and their inflammation induces symptoms and recurrence. Cyst wall enhancement is related to inflammation; however, its range and frequency have not yet been investigated. This study aimed to investigate the clinical and radiological differences between inflammatory and non-inflammatory Rathke cleft cysts. Methods Forty-one patients who underwent cyst decompression surgery for Rathke’s cleft cysts between January 2008 and July 2022 were retrospectively analyzed. Based on the pathological reports, patients were divided into inflammatory and non-inflammatory groups. Clinical assessments, endocrinological evaluations, cyst content analysis, and imaging metrics (mean computed tomographic value, maximum diameter, mean apparent diffusion coefficient [ADC] value, and qualitative features) were analyzed. Receiver operating characteristic curve analysis was performed, to determine ADC cutoff values, for differentiating inflammatory group from non-inflammatory group. Results Totally, 21 and 20 cases were categorized into the inflammatory and non-inflammatory groups, respectively. The inflammatory group displayed a higher incidence of central diabetes insipidus (arginine vasopressin deficiency) (p = 0.04), turbid cyst content (p = 0.03), significantly lower mean ADC values (p = 0.04), and more extensive circumferential wall enhancement on magnetic resonance imaging (MRI) (p < 0.001). In the inflammatory group, all cases revealed circumferential wall enhancement, with some exhibiting thick wall enhancement. There were no significant differences in other radiological features. The ADC cutoff value for differentiating the two groups was 1.57 × 10−3 mm2/s, showing a sensitivity of 81.3% and specificity of 66.7% Conclusion Inflammatory Rathke cleft cysts tended to show a higher incidence of central diabetes insipidus and turbid cyst content. Radiologically, they exhibited lower mean ADC values and greater circumferential wall enhancement on MRI.

show abstract

Rathke’s cleft cyst infections and pituitary abscesses: case series and review of the literature

Cited by 12 publications

References 29 publications

Case of an atypical pituitary abscess

Case of an atypical pituitary abscess

Pituitary Abnormalities

Comparison of clinical and radiological characteristics of inflammatory and non-inflammatory Rathke cleft cysts

Contact Info

Product

Resources

About