{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:27:12Z","timestamp":1789165632185,"version":"build-2803163510"},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":70,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg Rep"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Differentiating craniopharyngiomas (CPs) from Rathke's cleft cysts (RCCs) is challenging due to overlapping features. RCCs with squamous metaplasia (SM) may represent a transition to CPs, complicating diagnosis. This study presents a recurrent RCC later confirmed as papillary CP, prompting a systematic review to identify early diagnostic markers. The goal is to improve RCC and CP differentiation, preventing radical resection of true RCCs, and predicting recurrence or transformation to CPs.<\/jats:p>\n                  <jats:p>A systematic review was performed with adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Using the PubMed\/Medline databases, a search string was created with the keywords \u201cRCC transformation or (RCC and CP) or (RCC to CP) or (RCC to CP) or (Rathke's and CP).\u201d The initial search yielded 489 papers, narrowed by key data points including RCC recurrence with histologic CP confirmation.<\/jats:p>\n                  <jats:p>The final review included five studies, which detailed cases of initial pathological diagnosis of RCC that were later diagnosed as a CP upon repeat surgery and tissue sampling. Histological examination of primary and secondary surgical resections revealed RCC recurrence with transformation to CPs (two adamantinomatous CPs, two papillary CPs, and one ciliated CP).<\/jats:p>\n                  <jats:p>RCCs and CPs share overlapping features, complicating preoperative diagnosis and treatment. RCC recurrence with subsequent CP is rare, as our review identified only five recorded cases. Definitive diagnosis requires pathology, though sampling bias poses challenges. Advanced imaging (contrast-enhanced 3D T2-FLAIR MRI) and biomarkers (BRAF V600E, beta-catenin, p53, Ki-67) show promise in improving diagnosis, predicting recurrence, and guiding treatment.<\/jats:p>","DOI":"10.1055\/a-2751-8340","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T23:59:09Z","timestamp":1765411149000},"page":"e253-e259","source":"Crossref","is-referenced-by-count":2,"title":["Transformation Versus Ascertainment Bias of a Suprasellar Lesion: A Histopathologic Conundrum of BRAF V600E Positive Papillary Craniopharyngioma Versus Rathke's Cleft Cyst with Squamous Metaplasia: A Systematic Review"],"prefix":"10.1055","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8567-9242","authenticated-orcid":false,"given":"Hailey","family":"Mattheisen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin and Froedtert Hospital, Wauwatosa, Wisconsin, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samon","family":"Tavakoli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin and Froedtert Hospital, Wauwatosa, Wisconsin, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward Kelly","family":"Mrachek","sequence":"additional","affiliation":[{"name":"Department of Pathology, Medical College of Wisconsin and Froedtert Hospital, Wauwatosa, Wisconsin, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Cheok","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin and Froedtert Hospital, Wauwatosa, Wisconsin, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Zwagerman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin and Froedtert Hospital, Wauwatosa, Wisconsin, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.path.2020.02.006","article-title":"Sellar tumors","volume":"13","author":"K E Schwetye","year":"2020","journal-title":"Surg Pathol Clin"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/B978-0-444-59602-4.00017-4","article-title":"Rathke's cleft cyst","volume":"124","author":"S Larkin","year":"2014","journal-title":"Handb Clin Neurol"},{"key":"ref4","doi-asserted-by":"crossref","volume-title":"Radiology of the Pituitary","author":"J Evanson","DOI":"10.1016\/B978-0-12-801238-3.65233-9"},{"issue":"10","key":"ref5","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1016\/j.jocn.2015.05.001","article-title":"Intrasphenoidal Rathke's cleft cyst","volume":"22","author":"M K Kasliwal","year":"2015","journal-title":"J Clin Neurosci"},{"issue":"02","key":"ref6","first-page":"82","article-title":"Clinicopathological study of Rathke's cleft cysts","volume":"21","author":"H Ikeda","year":"2002","journal-title":"Clin Neuropathol"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"177","DOI":"10.5414\/NPP28177","article-title":"Late development of craniopharyngioma following surgery for Rathke's cleft cyst","volume":"28","author":"Y S Park","year":"2009","journal-title":"Clin Neuropathol"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"250","DOI":"10.3171\/2014.11.PEDS14370","article-title":"Craniopharyngioma arising in a Rathke's cleft cyst: case report","volume":"15","author":"A K Alomari","year":"2015","journal-title":"J Neurosurg Pediatr"},{"issue":"08","key":"ref9","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1093\/neuonc\/noab106","article-title":"The 2021 WHO classification of tumors of the central nervous system: a summary","volume":"23","author":"D N Louis","year":"2021","journal-title":"Neuro-oncol"},{"key":"ref10","volume-title":"Craniopharyngioma","author":"M Ortiz Torres"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1111\/nan.12201","article-title":"BRAF V600E analysis for the differentiation of papillary craniopharyngiomas and Rathke's cleft cysts","volume":"41","author":"L Schweizer","year":"2015","journal-title":"Neuropathol Appl Neurobiol"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s11060-015-1757-6","article-title":"BRAF V600E mutation is a useful marker for differentiating Rathke's cleft cyst with squamous metaplasia from papillary craniopharyngioma","volume":"123","author":"J H Kim","year":"2015","journal-title":"J Neurooncol"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"CNS106","DOI":"10.2217\/cns-2023-0018","article-title":"Promising response to vemurafenib and cobimetinib treatment for BRAF V600E mutated craniopharyngioma: a case report and literature review","volume":"13","author":"N Yu","year":"2024","journal-title":"CNS Oncol"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2217\/cns-2016-0034","article-title":"BRAF-V600E mutant papillary craniopharyngioma dramatically responds to combination BRAF and MEK inhibitors","volume":"6","author":"A Roque","year":"2017","journal-title":"CNS Oncol"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1055\/s-0032-1304814","article-title":"Giant suprasellar Rathke's cleft cyst mimicking craniopharyngioma: implications for a spectrum of cystic epithelial lesions of ectodermal origin","volume":"73","author":"O J Choudhry","year":"2012","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"issue":"06","key":"ref18","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.3171\/jns.1994.80.6.1018","article-title":"Epithelial cystic lesions of the sellar and parasellar region: a continuum of ectodermal derivatives?","volume":"80","author":"M J Harrison","year":"1994","journal-title":"J Neurosurg"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1093\/neuros\/nyy285","article-title":"Intratumoral Rathke's cleft cyst remnants within craniopharyngioma, pituitary adenoma, suprasellar dermoid, and epidermoid cysts: a ubiquitous signature of ectodermal lineage or a transitional entity?","volume":"85","author":"S Manjila","year":"2019","journal-title":"Neurosurgery"},{"issue":"06","key":"ref20","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.3171\/2009.10.JNS091265","article-title":"A Rathke cleft cyst to craniopharyngioma: is there a spectrum?","volume":"112","author":"S Q Wolfe","year":"2010","journal-title":"J Neurosurg"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"77","DOI":"10.3171\/jns.1966.24.1.0077","article-title":"Intrasellar epithelial cysts","volume":"24","author":"C A Fager","year":"1966","journal-title":"J Neurosurg"},{"issue":"06","key":"ref22","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1007\/s11102-015-0669-y","article-title":"Targeted BRAF and CTNNB1 next-generation sequencing allows proper classification of nonadenomatous lesions of the sellar region in samples with limiting amounts of lesional cells","volume":"18","author":"G Marucci","year":"2015","journal-title":"Pituitary"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s12022-007-0011-y","article-title":"Comparative immunohistochemical assessment of craniopharyngioma and related lesions","volume":"18","author":"B H Le","year":"2007","journal-title":"Endocr Pathol"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"29731","DOI":"10.1038\/srep29731","article-title":"EpCAM (CD326) is differentially expressed in craniopharyngioma subtypes and Rathke's cleft cysts","volume":"6","author":"V Thimsen","year":"2016","journal-title":"Sci Rep"},{"issue":"06","key":"ref25","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1093\/ons\/opy258","article-title":"Recurrent Rathke's cleft cysts: incidence and surgical management in a tertiary pituitary center over 2 decades","volume":"16","author":"M A Wedemeyer","year":"2019","journal-title":"Oper Neurosurg (Hagerstown)"},{"issue":"04","key":"ref26","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1038\/modpathol.2014.150","article-title":"Cross-reactivity of the BRAF VE1 antibody with epitopes in axonemal dyneins leads to staining of cilia","volume":"28","author":"R T Jones","year":"2015","journal-title":"Mod Pathol"},{"issue":"02","key":"ref27","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1056\/NEJMoa2213329","article-title":"BRAF-MEK inhibition in newly diagnosed papillary craniopharyngiomas","volume":"389","author":"P K Brastianos","year":"2023","journal-title":"N Engl J Med"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s10143-018-0978-5","article-title":"Histopathological and molecular predictors of growth patterns and recurrence in craniopharyngiomas: a systematic review","volume":"43","author":"J R Coury","year":"2020","journal-title":"Neurosurg Rev"},{"issue":"01","key":"ref29","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4103\/0028-3886.60402","article-title":"Is there a need to diagnose Rathke's cleft cyst preoperatively?","volume":"58","author":"A Raghunath","year":"2010","journal-title":"Neurol India"},{"issue":"06","key":"ref30","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1210\/clinem\/dgac033","article-title":"Approach to the patient: differential diagnosis of cystic sellar lesions","volume":"107","author":"M R Gadelha","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"issue":"01","key":"ref31","doi-asserted-by":"crossref","first-page":"106","DOI":"10.3174\/ajnr.A6359","article-title":"Usefulness of contrast-enhanced 3D-FLAIR MR imaging for differentiating Rathke cleft cyst from cystic craniopharyngioma","volume":"41","author":"M Azuma","year":"2020","journal-title":"AJNR Am J Neuroradiol"},{"issue":"04","key":"ref32","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s11102-023-01326-3","article-title":"Clinical and imaging findings for the evaluation of large Rathke's cleft cysts and cystic craniopharyngiomas","volume":"26","author":"C H Yang","year":"2023","journal-title":"Pituitary"},{"issue":"04","key":"ref33","doi-asserted-by":"crossref","first-page":"E4","DOI":"10.3171\/2010.2.FOCUS09318","article-title":"Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships","volume":"28","author":"G Zada","year":"2010","journal-title":"Neurosurg Focus"},{"issue":"02","key":"ref34","doi-asserted-by":"crossref","first-page":"189","DOI":"10.3171\/jns.2005.102.2.0189","article-title":"Surgical outcomes in 118 patients with Rathke cleft cysts","volume":"102","author":"C J Aho","year":"2005","journal-title":"J Neurosurg"},{"issue":"05","key":"ref35","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.neuchi.2022.01.002","article-title":"Rapidly recurrent recalcitrant Rathke cleft cyst: case report and review of the literature","volume":"68","author":"E J Chalif","year":"2022","journal-title":"Neurochirurgie"},{"issue":"03","key":"ref36","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.jocn.2013.07.008","article-title":"Rathke's cleft cyst recurrence after transsphenoidal surgery: a meta-analysis of 1151 cases","volume":"21","author":"Z S Mendelson","year":"2014","journal-title":"J Clin Neurosci"},{"issue":"03","key":"ref37","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1227\/01.NEU.0000374768.16291.03","article-title":"Endocrinopathy, vision, headache, and recurrence after transsphenoidal surgery for Rathke cleft cysts","volume":"67","author":"S D Wait","year":"2010","journal-title":"Neurosurgery"},{"issue":"04","key":"ref38","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.3171\/2015.8.JNS151282","article-title":"The long-term recurrence of Rathke's cleft cysts as predicted by histology but not by surgical procedure","volume":"125","author":"Y Kinoshita","year":"2016","journal-title":"J Neurosurg"},{"issue":"07","key":"ref39","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/j.clineuro.2006.01.007","article-title":"Clinico-pathological and immunohistochemical characteristics associated to recurrence\/regrowth of craniopharyngiomas","volume":"108","author":"M L Tena-Suck","year":"2006","journal-title":"Clin Neurol Neurosurg"},{"issue":"04","key":"ref40","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1093\/neuros\/nyz523","article-title":"Stereotactic radiation as salvage therapy for recurrent Rathke Cleft Cysts","volume":"87","author":"P K Agarwalla","year":"2020","journal-title":"Neurosurgery"},{"issue":"04","key":"ref41","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1007\/s12022-014-9328-5","article-title":"Spontaneous alteration from Rathke's cleft cyst to craniopharyngioma\u2013possible involvement of transformation between these pathologies","volume":"25","author":"Y Ogawa","year":"2014","journal-title":"Endocr Pathol"},{"issue":"02","key":"ref42","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/s00701-009-0448-5","article-title":"Ciliated craniopharyngioma\u2013case report and pathological study","volume":"152","author":"T Okada","year":"2010","journal-title":"Acta Neurochir (Wien)"},{"issue":"02","key":"ref43","doi-asserted-by":"crossref","first-page":"403","DOI":"10.4103\/ni.ni_1210_21","article-title":"Rathke's cleft cyst and craniopharyngioma: a continuum of the same spectrum? Insights from an Interesting case and previous literature","volume":"72","author":"R Sharma","year":"2024","journal-title":"Neurol India"}],"container-title":["Journal of Neurological Surgery Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2751-8340.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T23:59:15Z","timestamp":1765411155000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2751-8340"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":40,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2025,10,3]]},"published-print":{"date-parts":[[2025,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2751-8340","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6358","2193-6366"],"issn-type":[{"value":"2193-6358","type":"print"},{"value":"2193-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}