Journal of Neuro-Oncology

, Volume 117, Issue 2, pp 197–203

Rathke’s cleft cysts: review of natural history and surgical outcomes

  • Seunggu J. Han
  • John D. Rolston
  • Arman Jahangiri
  • Manish K. Aghi
Topic Review

DOI: 10.1007/s11060-013-1272-6

Cite this article as:
Han, S.J., Rolston, J.D., Jahangiri, A. et al. J Neurooncol (2014) 117: 197. doi:10.1007/s11060-013-1272-6

Abstract

Rathke’s cleft cysts (RCCs), also known as pars intermedia cysts, represent benign lesions formed from remnants of the embryologic Rathke’s pouch. Commonly asymptomatic, they are identified in nearly 1 in 6 healthy volunteers undergoing brain imaging. When symptomatic, they can cause headaches, endocrine dysfunction, and, rarely, visual disturbances. A systematic review of the published English literature was performed focusing on large modern case series of RCCs to describe their natural history, clinicopathologic features, radiographic features, and surgical outcomes, including rates of recurrence. The natural history of asymptomatic RCCs is one of slow growth, suggesting that observation through serial magnetic resonance imaging is appropriate for smaller asymptomatic RCCs. Symptomatic RCCs can be treated by surgical resection with low morbidity, usually through an endonasal transsphenoidal corridor using either a microscope or an endoscope. Surgical treatment frequently provides symptomatic relief of headaches and visual disturbances, and sometimes even improves endocrine dysfunction. Rates of recurrence after surgical treatment range from 16 to 18 % in large series, and higher rates of recurrence are associated with suprasellar location, inflammation and reactive squamous metaplasia in the cyst wall, superinfection of the cyst, and use of a fat graft into the cyst cavity.

Keywords

Rathke’s cleft cystSuprasellarRecurrence ratesRathke’s pouchPars intermedia cyst

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Seunggu J. Han
    • 1
  • John D. Rolston
    • 1
  • Arman Jahangiri
    • 1
  • Manish K. Aghi
    • 1
    • 2
    • 3
  1. 1.Department of Neurological SurgeryUniversity of California at San Francisco (UCSF)San FranciscoUSA
  2. 2.Center for Minimally Invasive Skull Base Surgery (MISB)San FranciscoUSA
  3. 3.The California Center for Pituitary Disorders (CCPD)San FranciscoUSA