A Rare Case of Rathke's Cleft Cyst-Induced Panhypopituitarism Resolved After Partial Resection

Chih-Kang Wan ； Chung-Mo Chang ； Ching-Ling Lin

《Formosan Journal of Endocrinology and Metabolism》 10卷 (2019/12) Pp. 7-10

https://doi.org/10.6856/FJEM.201912_10.0002

摘要

Background. Rathke's cleft cysts (RCCs) are generally considered as benign lesions, and they remain asymptomatic throughout the life. However, RCCs could become symptomatic if the adjacent structures are compressed, causing neurological deficits or endocrinological disturbances. Among symptomatic RCCs, panhypopituitarism is an uncommon condition in which the pituitary function rarely recovers after surgical decompression. Methods. We herein present a rare case of RCC-induced panhypopituitarism with resolved pituitary dysfunction after subtotal resection. Results. A 59-year-old male patient who presented with recurrent hyponatremia for 1.5 years. Imaging revealed a 1.4-cm intrasuprasellar lesion consistent with RCCs. He underwent endonasal transsphenoidal surgery, and subtotal resection was achieved with no intraoperative complications. The pituitary function was restored, and postoperative hormone replacement therapy was discontinued. Subsequent hormonal follow up showed complete restoration of hormonal profile. Conclusion. Most RCCs are small, asymptomatic with benign clinical course and often found incidentally by image study. However when symptomatic panhypopituitarism could be one of the manifestations. Our case suggested that even with partial resection RCC-induced panhypopituitarism can be resolved effectively without sequelae.

關鍵字

Rathke's cleft cysts ； pituitary ； panhypopituitarism