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Rathke's cleft cyst

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https://www.readbyqxmd.com/read/29610617/rathke-s-cleft-cyst-or-pituitary-apoplexy-a-case-report-and-literature-review
#1
Jeton Shatri, Ilir Ahmetgjekaj
BACKGROUND: During the examination of the sellar region by magnetic resonance imaging, hyperintensity in T1 weighted is a common finding. This signal intensity has different sources, and its significance depends on the clinical context. Pathologic variations in T1 signal hyperintensity may be related to clotting of blood (pituitary apoplexy) or the presence of a high concentration of protein (Rathke cleft cyst). The purpose of this study is to describe the significance of intracystic nodule, a diagnostic characteristic found in Rathke's cleft cyst, on MRI...
March 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29588899/combined-frontotemporal-transbasal-approach-for-the-resection-of-a-giant-rathke-s-cleft-cyst-operative-video-and-technical-nuances
#2
James K Liu
We present a case of a giant Rathke's cleft cyst with significant superior extension into the third and right lateral ventricles and lateral extension into the left Sylvian fissure and over the anterior clinoid process. An extended modification of the frontotemporal approach was performed using a combined frontotemporal transbasal approach. This allowed wide exposure to both transsylvian and subfrontal corridors to the retrochiasmatic space. This video atlas demonstrates the operative technique and surgical nuances of the skull base approach, microdissection of the tumor, and safe handling of the neurovascular structures...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29572168/lymphocytic-hypophysitis-secondary-to-ruptured-rathke-s-cleft-cyst-case-report-and-literature-review
#3
Chengxian Yang, Huanwen Wu, Xinjie Bao, Renzhi Wang
BACKGROUND: Lymphocytic hypophysitis (LH) is a rare inflammatory lesion in sellar region. LH secondary to ruptured Rathke's cleft cyst (RCC) is even more rarely observed according to published case reports. The clinical characteristics, treatment strategies and prognosis of such lesions remain elusive. CASE DESCRIPTION: A 58-year-old Chinese woman was admitted to our hospital complaining of initial intermittent headache for 3 years and new development of polydipsia, polyuria, and binocular visual acuity decline for recent 4 months...
March 20, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29554412/incidence-of-epistaxis-after-endoscopic-pituitary-surgery-proposed-treatment-algorithm
#4
Lee A Zimmer, Norberto Andaluz
Endoscopic transsphenoidal surgery for pituitary tumors is an increasingly common practice. Little has been reported on the incidence and treatment of postoperative epistaxis in this population. The aim of this study was to analyze the incidence of postoperative epistaxis and formulate a treatment algorithm based on our experience. We performed a case series with chart review. A total of 434 consecutive patients who had endoscopic transsphenoidal pituitary surgery were identified between April 2006 and November 2013...
March 2018: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29552263/rathke-s-cleft-cyst-associated-with-pituitary-granulomatosis-with-polyangiitis-an-unusual-combination-of-hypothalamus-pituitary-region-pathologies
#5
Riccardo Draghi, Giovanna Mantovani, Letterio Runza, Giorgio Carrabba, Nicola Fusco, Paolo Rampini, Antonella Costa, Marco Locatelli
The authors present an unusual case of a patient suffering from visual deficit due to pituitary granulomatosis with polyangiitis (GPA) associated with Rathke's cleft cyst (RCC). The patient was referred to our Neurosurgery Department presenting right eye amaurosis, third cranial nerve palsy, and left temporal hemianopsia. Magnetic resonance imaging documented a sellar or suprasellar lesion with solid and cystic components. The dura mater of the skull base was also strongly enhanced. The patient underwent surgery...
February 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29520296/rathke-s-cleft-cyst-as-origin-of-a-pediatric-papillary-craniopharyngioma
#6
Sven-Martin Schlaffer, Michael Buchfelder, Robert Stoehr, Rolf Buslei, Annett Hölsken
A 6-year old patient presented with an intra and suprasellar cystic lesion accompanied with impairment of the hypothalamic-pituitary axis and partial hypopituitarism. The most likely cause of sellar lesions in this age group are adamantinomatous craniopharyngioma (adaCP) or Rathke´s cleft cysts (RCCs). AdaCP are characterized by CTNNB1 mutations accompanied with aberrant nuclear beta-catenin expression. RCC show neither nuclear beta-catenin expression nor BRAF mutation. The latter is a hallmark of papillary craniopharyngiomas (papCP) that exhibit remarkable histological similarity with metaplasia of RCC...
2018: Frontiers in Genetics
https://www.readbyqxmd.com/read/29498601/edema-of-the-optic-tract-in-patients-with-tumors-of-the-sellar-region-clinical-and-visual-implications-in-the-pediatric-population
#7
Aurore Bussat, Maia Proisy, Bertrand Bruneau, Guillaume Bouzillé, Céline Chappé, Laurent Riffaud
OBJECTIVE Tumor-related edema of the optic tract (EOT) corresponds to a preferential posterior distribution of peritumoral edema along the white matter tract of the visual system. To date, the consequences of EOT have never been evaluated specifically in the pediatric population. In this study, the authors attempted to identify clinical and radiological features associated with the development of EOT and the specific influence of this edema on visual function. METHODS A retrospective review was performed of data collected from patients younger than 18 years who underwent surgery for a tumor in the sellar region at the authors' institution between January 2005 and January 2016...
March 2, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29497568/suprasellar-keratinous-cyst-a-case-report-and-review-on-its-radiological-features-and-treatment-outcome
#8
C W Huo, C Caputo, Y Y Wang
Background: Keratinous or epidermoid cysts (ECs) are encapsulated lesions lined by squamous cell epithelium. They comprise approximately 1% of intracranial lesions. Contrary to dermoid cysts, they lack dermal elements such as sebaceous or apocrine glands and hair follicles. The sellar region is the second most common intracranial site following the cerebellopontine angle. Here, we report a case of EC in a patient who complained of endocrine disturbances. We also performed a systematic review on previously published cases to analyze clinical and radiological characteristics and report the treatment outcomes of suprasellar ECs...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29494890/outcome-of-diabetes-insipidus-in-patients-with-rathke-s-cleft-cysts
#9
Masahiro Oishi, Yasuhiko Hayashi, Yasuo Sasagawa, Daisuke Kita, Osamu Tachibana, Mitsutoshi Nakada
OBJECTIVES: It is well-known that Rathke's cleft cysts (RCCs) infrequently cause headache, endocrinological dysfunction, and visual disturbance, and in rare cases, cause diabetes insipidus (DI). Although surgical evacuation of the cyst content can result in high rates of symptomatic improvement, not only the treatment efficacy but also the pathophysiology of DI with RCC are undetermined. The aim of this study is to elucidate the underlying mechanisms and outcomes of DI associated with RCCs...
February 21, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29456852/xanthogranulomatous-pituitary-adenoma-a-case-report-and-literature-review
#10
Guihong Li, Chaochao Zhang, Yuxue Sun, Qingchun Mu, Haiyan Huang
Xanthogranuloma, also referred to as cholesterol granuloma or xanthogranulomatous reaction, is a granulomatous lesion that is infrequently found in the sellar and parasellar regions. Xanthogranulomatous pituitary adenoma is relatively rare and, thus, the etiology, diagnosis, management and prognosis of this condition remain incompletely understood. We herein report the case of a 56-year-old female patient who presented to our institution with intermittent headache, vomiting and distending pain in the bilateral orbital regions...
March 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29445918/persistent-craniopharyngeal-canal-bilateral-microphthalmia-with-colobomatous-cysts-ectopic-adenohypophysis-with-rathke-cleft-cyst-and-ectopic-neurohypophysis-case-report-and-review-of-the-literature
#11
Nazlı Gülsüm Akyel, Ayşe Gül Alımlı, Tülin Hakan Demirkan, Mesut Sivri
INTRODUCTION: Persistent craniopharyngeal canal (PCC) is a rare anomaly of the base of the skull. PCC is defined as a well-corticated osseous canal, extending from the roof of the nasopharynx to the base of the sella over the course of the sphenoid corpus. We reported a PCC case with unique associations. The magnetic resonance imaging findings are discussed. CASE PRESENTATION: We report a case of a 2-year-old boy with persistent craniopharyngeal canal, bilateral microphtalmia with large colobomatous cyst, and ectopic adenohypophysis with Rathke cleft cyst...
February 14, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29431099/abscess-inside-craniopharyngioma-diagnostic-and-management-implications
#12
Kamlesh Singh Bhaisora, Surya Nandan Prasad, Kuntal Kanti Das, Hira Lal
Abscess inside the pituitary fossa is very rare. Such abscess can be primary, occurring in an otherwise healthy pituitary gland, or secondary, developing inside a diseased gland (ie, harbouring craniopharyngioma, Rathke's cleft cyst, etc). Secondary pituitary abscess inside a craniopharyngioma remains an extremely rare occurrence. Our literature search revealed only six such cases reported so far. In this report, we present the seventh case of craniopharyngioma with abscess in a 38-year-old woman. We describe the uniqueness of the clinical presentation of our case, the radiological pointers to the possible diagnosis and the management issues in our patient...
February 3, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29425985/clinical-features-and-treatment-of-secondary-pituitary-abscess-following-transsphenoidal-surgery-a-retrospective-study-of-23-cases
#13
Ziquan Li, Chengxian Yang, Xinjie Bao, Yong Yao, Ming Feng, Kan Deng, Xiaohai Liu, Bing Xing, Renzhi Wang
OBJECTIVE: Pituitary abscess (PA) is a rare but serious intrasellar disorder with potentially high disability and mortality. Secondary PA following transsphenoidal surgery (TS) is extremely rare and only a few case reports were identified in the literature. This study explored the salient clinical manifestations and etiologies to determine appropriate treatment. METHODS: A retrospective review of 6,832 consecutive patients who had undergone transsphenoidal surgery for pituitary diseases in Peking Union Medical College Hospital between 2003 and 2017 was performed...
February 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29404255/one-piece-orbitozygomatic-craniotomy-for-resection-of-rathke-s-cleft-cyst-operative-video
#14
Rimal H Dossani, Devi P Patra, Christopher Storey, Piyush Kalakoti, Hai Sun
Objective  The video stars orbitozygomatic resection of Rathke's cleft cyst with suprasellar extension in a 37-year-old male patient presenting with severe headaches and bitemporal hemianopia. Clinical and radiological characteristics along with surgical technique (positioning, bony opening, surgical dissection and debulking, closure), histopathology, and postoperative course are described. Methods  Preoperative MRI demonstrated a noncontrast-enhancing cystic lesion in the sella with suprasellar extension causing compression of both optic nerves...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29388032/the-diagnostic-value-of-preoperative-inflammatory-markers-in-craniopharyngioma-a-multicenter-cohort-study
#15
Ming Chen, Shi-Hao Zheng, Min Yang, Zhi-Hua Chen, Shi-Ting Li
To compare the different levels of preoperative inflammatory markers in peripheral blood samples between craniopharyngioma (CP) and other sellar region tumors so as to explore their differential diagnostic value. The level of white blood cell (WBC), neutrophil, lymphocyte, monocyte, platelet, albumin, neutrophil lymphocyte ratio (NLR), derived NLR (dNLR), platelet lymphocyte ratio (PLR), monocyte lymphocyte ratio (MLR) and prognostic nutritional index (PNI) were compared between the CP and other sellar region tumors...
January 31, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29379387/factors-affecting-visual-field-outcome-post-surgery-in-sellar-region-tumors-retrospective-study
#16
Prabu Rau Sriram, Puliventhan Sellamuthu, Abdul Rahman Izani Ghani
Background: Despite the broad category of differentials for sellar region, most of them present with similar clinical signs and symptoms. Headache and visual disturbance are among the frequently seen as presenting symptom. Visual field (VF) assessment is one of the crucial component of neuroophtalmologic assessment and mean deviation (MD) value from automated perimetry allows quantification of the visual field defect. We formulated a study to look into the factors that affect the visual field outcome after surgery...
December 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29363000/pituitary-xanthogranulomas-clinical-features-radiological-appearances-and-post-operative-outcomes
#17
R Ved, N Logier, P Leach, J S Davies, C Hayhurst
BACKGROUND: Xanthogranulomas are inflammatory masses most commonly found at peripheral sites such as the skin. Sellar and parasellar xanthogranulomas are rare and present a diagnostic challenge as they are difficult to differentiate from other sellar lesions such as craniopharyngiomas and Rathke's cleft cysts pre-operatively. Their radiological imaging features are yet to be clearly defined, and clinical outcomes after surgery are also uncertain. This study reviews clinical presentation, radiological appearances, and clinical outcomes in a cohort of patients with pituitary xanthogranulomas...
January 23, 2018: Pituitary
https://www.readbyqxmd.com/read/29309984/headache-resolution-after-rathke-cleft-cyst-resection-a-meta-analysis
#18
Njoud Altuwaijri, David J Cote, Nayan Lamba, Walaa Albenayan, Steven P Ren, Iman Zaghloul, Joanne Doucette, Hasan A Zaidi, Rania A Mekary, Timothy R Smith
OBJECTIVE: Rathke cleft cysts (RCC) are benign lesions of the sella that often present with headache. It is not currently well established whether surgical resection of RCC results in resolution of headache. We conducted a meta-analysis to examine the effect of RCC resection on headache resolution. METHODS: PubMed, EMBASE, and Cochrane databases were searched through June 2017 for articles that evaluated the effect of RCC resection on headache resolution. Pooled effect estimates were calculated using fixed-effects and random-effects models...
March 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29248982/a-case-series-of-atypical-features-of-patients-with-biopsy-proven-isolated-igg4-related-hypophysitis-and-normal-serum-igg4-levels
#19
Kevin C J Yuen, Kelley J Moloney, Jennifer U Mercado, Steven Rostad, Brendan J McCullough, Zachary N Litvack, Johnny B Delashaw, Marc R Mayberg
BACKGROUND: IgG4-related hypophysitis is a rare clinical entity that forms part of an emerging group of multi-organ IgG4-related fibrosclerotic systemic diseases. The rare prevalence of the disease, presenting features that overlap with other sellar pathologies, and variable imaging features can make preoperative identification challenging. PURPOSE AND METHODS: We report three cases of isolated IgG4-related hypophysitis with atypical clinical and imaging features that mimicked those of pituitary apoplexy and other sellar lesions...
December 16, 2017: Pituitary
https://www.readbyqxmd.com/read/29239033/what-s-new-in-pituitary-pathology
#20
REVIEW
Sylvia L Asa, Ozgur Mete
The increasing recognition of pituitary disorders and their impact on quality of life and longevity has made understanding of this small gland a subject of paramount importance. Pituitary pathology has seen many significant studies that indicate progress in identification and classification of pituitary lesions, as well as improved management strategies for patients. In this review, we outline six major areas of advances: (i) changes in terminology from 'adenoma' to 'pituitary neuroendocrine tumour'; (ii) reclassification of hormone-negative tumours based on transcription factor expression that defines lineage; (iii) updates in new pathogenetic mechanisms, including those that underlie rare lesions such as X-LAG and pituitary blastoma; (iv) clarification of hypophysitis due to immunotherapy, xanthomatous hypophysitis due to rupture of a Rathke's cleft cyst and IgG4 disease as the cause of inflammatory pseudotumour; (v) the consolidation of pituicytoma variants, including spindle cell oncocytoma and granular cell tumour based on thyroid transcription factor-1 (TTF-1) reactivity; and (vi) the pathogenetic mechanisms that distinguish papillary from adamantinomatous craniopharyngioma...
January 2018: Histopathology
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