open access

Vol 72, No 5 (2021)
Original paper
Submitted: 2021-07-07
Accepted: 2021-08-27
Published online: 2021-10-22
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Presenting symptoms and endocrine dysfunction in Rathke cleft cysts — a two-centre experience

Daniela Dadej1, Katrina Skraba1, Beata Matyjaszek-Matuszek2, Joanna Świrska2, Marek Ruchała1, Katarzyna Ziemnicka1
DOI: 10.5603/EP.a2021.0091
·
Endokrynologia Polska 2021;72(5):505-511.
Affiliations
  1. Department of Endocrinology, Metabolism, and Internal Medicine, Poznan University of Medical Sciences, Poland
  2. Department of Endocrinology, Medical University in Lublin, Poland

open access

Vol 72, No 5 (2021)
Original Paper
Submitted: 2021-07-07
Accepted: 2021-08-27
Published online: 2021-10-22

Abstract

Introduction: Rathke cleft cysts (RCC) arise as developmental abnormalities of the pituitary gland and are usually diagnosed incidentally. However, they may present with headaches, visual impairment, or pituitary dysfunction. Rathke cleft cysts are poorly described in the Polish literature. We aimed to characterize presenting symptoms, associated endocrine dysfunction, and concomitant disorders in the Polish population of patients with RCC.

Material and methods: We performed a retrospective analysis of medical records of 102 patients diagnosed with RCC between 2006 and 2021 at Heliodor Swiecicki Clinical Hospital in Poznan and Independent Public Clinical Hospital No. 4 in Lublin.

Results: The cohort was 72% female, with a mean age of 43 years. The median maximal cyst diameter was 7 mm. The majority of subjects were overweight or obese and presented lipid profile or glucose disturbances. Common presenting symptoms included headache, vertigo, and visual impairment. Less frequently we observed sexual dysfunction, irregular menses, galactorrhoea, or fatigue. Hormonal abnormalities were identified in 30% of patients, with hyperprolactinaemia being the commonest endocrinopathy (23%). Pituitary function in patients with RCC did not correlate with cyst size. Both concomitant pituitary adenomas and pineal cysts were diagnosed in 3% of patients. A considerable proportion of subjects were diagnosed with Hashimoto’s thyroiditis and multinodular goitre.

Conclusions: RCCs occur mostly in females and may result in a variety of symptoms and hormonal dysfunction. Patients require a full clinical and endocrine evaluation regardless of the cyst diameter. We report a substantial co-occurrence of RCC and metabolic disorders and primary thyroid diseases, which requires further investigation. 

Abstract

Introduction: Rathke cleft cysts (RCC) arise as developmental abnormalities of the pituitary gland and are usually diagnosed incidentally. However, they may present with headaches, visual impairment, or pituitary dysfunction. Rathke cleft cysts are poorly described in the Polish literature. We aimed to characterize presenting symptoms, associated endocrine dysfunction, and concomitant disorders in the Polish population of patients with RCC.

Material and methods: We performed a retrospective analysis of medical records of 102 patients diagnosed with RCC between 2006 and 2021 at Heliodor Swiecicki Clinical Hospital in Poznan and Independent Public Clinical Hospital No. 4 in Lublin.

Results: The cohort was 72% female, with a mean age of 43 years. The median maximal cyst diameter was 7 mm. The majority of subjects were overweight or obese and presented lipid profile or glucose disturbances. Common presenting symptoms included headache, vertigo, and visual impairment. Less frequently we observed sexual dysfunction, irregular menses, galactorrhoea, or fatigue. Hormonal abnormalities were identified in 30% of patients, with hyperprolactinaemia being the commonest endocrinopathy (23%). Pituitary function in patients with RCC did not correlate with cyst size. Both concomitant pituitary adenomas and pineal cysts were diagnosed in 3% of patients. A considerable proportion of subjects were diagnosed with Hashimoto’s thyroiditis and multinodular goitre.

Conclusions: RCCs occur mostly in females and may result in a variety of symptoms and hormonal dysfunction. Patients require a full clinical and endocrine evaluation regardless of the cyst diameter. We report a substantial co-occurrence of RCC and metabolic disorders and primary thyroid diseases, which requires further investigation. 

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Keywords

cleft cysts; Rathke; pituitary incidentaloma; hyperprolactinaemia; hypopituitarism; headache

About this article
Title

Presenting symptoms and endocrine dysfunction in Rathke cleft cysts — a two-centre experience

Journal

Endokrynologia Polska

Issue

Vol 72, No 5 (2021)

Article type

Original paper

Pages

505-511

Published online

2021-10-22

DOI

10.5603/EP.a2021.0091

Bibliographic record

Endokrynologia Polska 2021;72(5):505-511.

Keywords

cleft cysts
Rathke
pituitary incidentaloma
hyperprolactinaemia
hypopituitarism
headache

Authors

Daniela Dadej
Katrina Skraba
Beata Matyjaszek-Matuszek
Joanna Świrska
Marek Ruchała
Katarzyna Ziemnicka

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