Natural history and surgical outcomes of Rathke's cleft cysts: a Spanish multicenter study
Por:
Menéndez-Torre, EL, Gutiérrez-Hurtado, A, Ollero, MD, Irigaray, A, Martín, P, Parra, P, González-Molero, I, Araujo-Castro, M, Idrobo, C, Moure, MD, Molina, AR, Biagetti, B, Iglesias, P, Paja, M, Villar-Taibo, R, Pena, A, Vicente, A, Guerrero-Pérez, F, Cordido, F, Aulinas, A, Mateu, M, Soto, A
Publicada:
17 jun 2024
Resumen:
Rathke's cleft cysts (RCC) are a common type of lesion found in the sellar or suprasellar area. They are usually monitored clinically, but in some cases, surgery may be required. However, their natural progression is not yet well understood, and the outcomes of surgery are uncertain. The objective of this study is to evaluate the natural history of Rathke's cleft cysts in patients who are clinically monitored without treatment, and to determine the outcomes of surgery and the incidence of recurrences over time.Design and patients National multicentric study of patients diagnosed of Rathke's cleft cyst (RCC- Spain) from 2000 onwards and followed in 15 tertiary centers of Spain. A total of 177 patients diagnosed of RCC followed for 67.3 months (6-215) and 88 patients who underwent surgery, (81 patients underwent immediate surgery after diagnosis and 7 later for subsequent growth) followed for 68.8 months (3-235).Results The cyst size remained stable or decreased in 73.5% (133) of the patients. Only 44 patients (24.3%) experienced a cyst increase and 9 of them (5.1%) experienced an increase greater than 3 mm. In most of the patients who underwent surgery headaches and visual alterations improved, recurrence was observed in 8 (9.1%) after a median time of 96 months, and no predictors of recurrence were discovered.Conclusions Rathke's cleft cysts without initial compressive symptoms have a low probability of growth, so conservative management is recommended. Patients who undergo transsphenoidal surgery experience rapid clinical improvement, and recurrences are infrequent. However, they can occur after a long period of time, although no predictors of recurrence have been identified.
Filiaciones:
Menéndez-Torre, EL:
Hosp Univ Cent Asturias, Dept Endocrinol & Nutr, Oviedo, Spain
Inst Invest Biomed Principado Asturias ISPA, Grp ENDO, Oviedo, Spain
Univ Oviedo, Dept Med, Oviedo, Spain
Gutiérrez-Hurtado, A:
Hosp Univ Cent Asturias, Dept Endocrinol & Nutr, Oviedo, Spain
Ollero, MD:
Hosp Univ Navarra, Dept Endocrinol & Nutr, Pamplona, Spain
Irigaray, A:
Hosp Univ Navarra, Dept Endocrinol & Nutr, Pamplona, Spain
Martín, P:
Hosp Univ La Paz, Dept Endocrinol & Nutr, Madrid, Spain
Parra, P:
Hosp Univ La Paz, Dept Endocrinol & Nutr, Madrid, Spain
González-Molero, I:
Hosp Reg Univ Malaga, Dept Endocrinol & Nutr, IBIMA Plataforma Bionand, Malaga 29010, Spain
Araujo-Castro, M:
Hosp Univ Ramon & Cajal, Dept Endocrinol & Nutr, Madrid, Spain
Idrobo, C:
Hosp Univ Ramon & Cajal, Dept Endocrinol & Nutr, Madrid, Spain
Moure, MD:
Hosp Univ Cruces, Dept Endocrinol & Nutr, Baracaldo, Spain
Molina, AR:
Hosp Univ Cruces, Dept Endocrinol & Nutr, Baracaldo, Spain
Biagetti, B:
Hosp Univ Vall dHebron, Dept Endocrinol & Nutr, Barcelona, Spain
Iglesias, P:
Hosp Univ Puerta de Hierro, Dept Endocrinol & Nutr, Madrid, Spain
Paja, M:
Hosp Univ Basurto, Dept Endocrinol & Nutr, Bilbao, Spain
Villar-Taibo, R:
Hosp Univ Santiago De Compostela, Dept Endocrinol & Nutr, Santiago De Compostela, Spain
Pena, A:
Hosp Univ Santiago De Compostela, Dept Endocrinol & Nutr, Santiago De Compostela, Spain
Vicente, A:
Hosp Univ Toledo, Dept Endocrinol & Nutr, Toledo, Spain
Guerrero-Pérez, F:
Hosp Univ Bellvitge, Dept Endocrinol & Nutr, Barcelona, Spain
Cordido, F:
Hosp Univ Coruna, Dept Endocrinol & Nutr, La Coruna, Spain
Aulinas, A:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Mateu, M:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Soto, A:
Hosp Univ Virgen Rocio, Dept Endocrinol & Nutr, Seville, Spain
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