ESPE Abstracts (2016) 86 P-P2-702

Clinical Analysis of 24 Cases of Rathke's Cleft Cysts in Children

You-jun Jiang, Ke Huang & Chao-chun Zou

Children’s Hospital of Zhejiang University School of Medicine, Hangzhou, China

Background: Rathke’s cleft cysts (RCC) are benign, epithelial lined cystic remnants of the craniopharyngeal duct, and are a common radiological differential for lesions involving the sellar and sellar/suprasellar region. RCC are not very common in children.

Objective and hypotheses: To investigate the clinical characteristics of RCC in children.

Method: A retrospective analysis was conducted in 24 patients with RCCs diagnosed between July 2010 and August 2015. Their clinical, hormonal, and imaging findings were reviewed.

Results: 24 patients with radiologically proven RCCs were lack of headaches, visual disturbances, adrenal dysfunction or hyperprolactinemia. 15 patients (62.5%) got growth retardation, and 7 of them (29.2%) were diagnosed idiopathic short stature, 8 of them (37.5%) were diagnosed growth hormone deficiency (GHD). In all GHD cases, 1 case had both GHD and central diabetes insipidus; 1 case had both GHD and central hypothyroidism. 6 cases had breast development before 8 years old and 3 of them (12.5%) were diagnosed central precocious puberty, Other 3 cases (12.5%) were diagnosed un-completely precocious puberty. 3 cases (12.5%) were obesity. Till February 2016, none of these 24 cases had headache or visual disturbance. All 24 cases were re-examined pituitary magnetic resonance and three of them were self-healing. 2 cases got undertook transsphenoidal pituitary cyst excision and 3 years follow-up, theirs Rathke cysts were not recurrenced.

Conclusion: RCCs in the pediatric population are known to be an infrequent cause of headaches and visual disturbances, but pituitary dysfunction are most common. Most of Rathke’s cleft cysts pediatric patients don’t need surgery, a few patients can heal itself.

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