ArticleEndocrine2019
High prevalence of adrenal insufficiency at diagnosis and headache recovery in surgically resected Rathke's cleft cysts-a large retrospective single center study.
Article in Endocrine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Recurrence of Rathke's cleft cysts based on gross total resection of cyst wall: a meta-analysis.Neurosurgical review · 2020Pooled it
- Long-term endocrine trajectories and reoperation risk after surgery for Rathke's cleft cysts: a single-center cohort study of 177 patients.Pituitary · 2026Article
- A rare case report of panhypopituitarism and suspected pituitary apoplexy secondary to Rathke cleft cyst.SAGE open medical case reports · 2026Article
- Pituitary incidentaloma: a Pituitary Society international consensus guideline statement.Nature reviews. Endocrinology · 2025Review
- High recurrence of rathke's cleft cysts with anterior-Inferior pituitary displacement despite standard surgical approaches.Pituitary · 2025Article
- Chiasmatic syndrome caused by Rathke's cleft cyst: A case report.Molecular and clinical oncology · 2025Article
- The endocrine spectrum of Rathke cleft cysts.Frontiers in endocrinology · 2025Review
- Inflammation of adenohypophysis is commonly associated with headache in surgically managed Rathke's cleft cysts.Pituitary · 2024Article
- Symptoms at presentation in conservatively managed patients with non-functioning pituitary adenomas.Hormones (Athens, Greece) · 2023Article
- A study on clinical outcomes of Rathke's cleft cyst in patients managed conservatively.Pituitary · 2022Article
- Incidence and factors associated with the recurrence of Rathke's cleft cyst after surgery: A systematic review and meta-analysis.Frontiers in surgery · 2022Review
- Incidence and risk factors of delayed postoperative hyponatremia after endoscopic endonasal surgery for Rathke's cleft cyst: A single-center study.Frontiers in surgery · 2022Article
- Hypophysitis, the Growing Spectrum of a Rare Pituitary Disease.The Journal of clinical endocrinology and metabolism · 2022Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRathke's cleft cysts (RCC) are lesions that arise from Rathke's pouch. Though frequently incidental, resulting symptoms in a minority of cases are indicators for surgical resection, which may prove beneficial.
objectiveTo characterize a cohort of surgically-resected RCC cases at Oregon Health & Science University; tabulate associated hormonal imbalances and symptoms, possible symptom reversal with surgery, determine recurrence risk; identify predictors of recurrence and headache improvement.
methodElectronic records of all RCC resected cases (from 2006-2016; 11 years) were retrospectively reviewed. Patients had been evaluated by one neuroendocrinologist using a uniform protocol.
resultsA pathological RCC diagnosis was established in 73 of 814 (9%) surgical pituitary cases. The RCC cohort was 77% (n = 56/73) female, mean age was 39.5 ± 14.9 years at first surgery, and at presentation headache was reported in 88% and visual defects/diplopia in 18% of patients. Initial RCC maximum diameter was 1.3 ± 0.7 cm. The most frequent hormonal deficit was cortisol; 24% of patients had a new adrenal insufficiency (AI) diagnosis, however, 36% also had AI at 3 months post-operatively. Mean follow up was 4.0 ± 4.5 years. Two-thirds of patients (41/62) had headache improvement 3 months post-operatively. Post-operative imaging revealed no residual cyst in 58% (38/65). In those patients with no residual RCC, 29% had recurrence and 71% had long lasting cure. From the 42% (27/65) of patients with residual cyst on post-operative imaging; 59% (16/27) remained stable, 26% (7/27) progressed and 15% (4/27) regressed.
conclusionSymptomatic RCC present mostly in women, with a high proportion reporting headaches. Prevalence of AI at diagnosis is high. Surgery may not achieve adrenal axis recovery, but renders a high percentage of headache improvement. Approximately 25% of RCC will recur by 4 years postoperatively. Clinicians should cautiously screen patients with symptomatic RCC, regardless of lesion size for AI.
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