{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T19:00:29Z","timestamp":1788634829470,"version":"build-2803163510"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Rathke\u2019s cleft cysts (RCCs) are relatively common and often detected incidentally. They are usually asymptomatic and managed conservatively. However, little is known about their natural history. Thus, the authors aimed to examine the natural course of RCCs and identify the risk factors for their progression.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n This retrospective study examined 229 patients (median age 43.0 years) diagnosed with RCCs by MRI and followed up without surgery (median period 36.6 months). The median cyst height on the initial MRI was 10 mm. Progression or regression of RCC was defined as cyst height changes of \u2265 1 mm.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n In total, 23 (10.0%) RCCs progressed, whereas 73 (31.9%) RCCs spontaneously regressed. The remaining 133 were noted to be stable throughout the follow-up period. Patients with progressed RCCs were significantly older than those with stable RCCs. In patients with acute headache as an initial symptom, RCCs were significantly more likely to spontaneously regress. New symptoms occurred in 6 patients, 5 of whom underwent surgery for RCC progression. Of these 6 patients, 1 patient had persistent adrenocorticotropic hormone deficiency and 1 patient developed diabetes insipidus. Kaplan-Meier analysis results showed RCC progression and new symptom development rates to be 12.0% and 4.1% at 5 years and 13.7% and 5.7% at 10 years, respectively.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n RCCs rarely progress or cause new symptoms in the long term. Patients with asymptomatic RCC should be followed up for at least 5 years to ensure RCC inactivity. RCCs in older adults may require greater surveillance.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2022.7.jns22716","type":"journal-article","created":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T11:01:50Z","timestamp":1662116510000},"page":"1426-1432","source":"Crossref","is-referenced-by-count":16,"title":["Natural course of Rathke\u2019s cleft cysts and risk factors for progression"],"prefix":"10.3171","volume":"138","author":[{"given":"Yasuyuki","family":"Kinoshita","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Taguchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiyuki","family":"Yamasaki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Tominaga","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neuro-Endovascular Therapy, Hiroshima Prefectural Hospital, Hiroshima; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunori","family":"Arita","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobutaka","family":"Horie","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Radiology","first-page":"161","article-title":"Incidental pituitary lesions in 1,000 unselected autopsy specimens","volume":"193","author":"Teramoto A","year":"1994","unstructured":"Teramoto A, Hirakawa K, Sanno N, Osamura Y. Incidental pituitary lesions in 1,000 unselected autopsy specimens. Radiology. 1994;193(1):161\u2013164."},{"issue":"2","key":"b2","series-title":"Pituitary","first-page":"285","article-title":"Surgical outcomes and quality of life in Rathke\u2019s cleft cysts undergoing endoscopic transsphenoidal resection: a multicentre study and systematic review of the literature","volume":"25","author":"Castle-Kirszbaum M","year":"2022","unstructured":"Castle-Kirszbaum M, Kam J, Wang YY, King J, Fryer K, Goldschlager T. Surgical outcomes and quality of life in Rathke\u2019s cleft cysts undergoing endoscopic transsphenoidal resection: a multicentre study and systematic review of the literature. Pituitary. 2022;25(2):285\u2013295."},{"issue":"4","key":"b3","series-title":"J Neurosurg","first-page":"1002","article-title":"The long-term recurrence of Rathke\u2019s cleft cysts as predicted by histology but not by surgical procedure","volume":"125","author":"Kinoshita Y","year":"2016","unstructured":"Kinoshita Y, Tominaga A, Usui S, The long-term recurrence of Rathke\u2019s cleft cysts as predicted by histology but not by surgical procedure. J Neurosurg. 2016;125(4):1002\u20131007."},{"issue":"2","key":"b4","series-title":"Eur J Endocrinol","first-page":"123","article-title":"A survey of pituitary incidentaloma in Japan","volume":"149","author":"Sanno N","year":"2003","unstructured":"Sanno N, Oyama K, Tahara S, Teramoto A, Kato Y. A survey of pituitary incidentaloma in Japan. Eur J Endocrinol. 2003;149(2):123\u2013127."},{"issue":"2","key":"b5","series-title":"J Neurosurg","first-page":"189","article-title":"Surgical outcomes in 118 patients with Rathke cleft cysts","volume":"102","author":"Aho CJ","year":"2005","unstructured":"Aho CJ, Liu C, Zelman V, Couldwell WT, Weiss MH. Surgical outcomes in 118 patients with Rathke cleft cysts. J Neurosurg. 2005;102(2):189\u2013193."},{"issue":"10","key":"b6","series-title":"J Clin Endocrinol Metab","first-page":"3943","article-title":"A case for conservative management: characterizing the natural history of radiographically diagnosed rathke cleft cysts","volume":"100","author":"Culver SA","year":"2015","unstructured":"Culver SA, Grober Y, Ornan DA, A case for conservative management: characterizing the natural history of radiographically diagnosed rathke cleft cysts. 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J Neurosurg Pediatr. 2018;21(3):308\u2013314."},{"issue":"4","key":"b9","series-title":"Pituitary","first-page":"362","article-title":"Rathke\u2019s cleft cysts: a 6-year experience of surgery vs. observation with comparative volumetric analysis","volume":"22","author":"Barkhoudarian G","year":"2019","unstructured":"Barkhoudarian G, Palejwala SK, Ansari S, Rathke\u2019s cleft cysts: a 6-year experience of surgery vs. observation with comparative volumetric analysis. Pituitary. 2019;22(4):362\u2013371."},{"issue":"2","key":"b10","series-title":"Neurochirurgie","first-page":"104","article-title":"Surgery versus conservative care for Rathke\u2019s cleft cyst","volume":"67","author":"Truong LUF","year":"2021","unstructured":"Truong LUF, Bazin C, Gomis P, Decoudier B, Delemer B, Litr\u00e9 CF. Surgery versus conservative care for Rathke\u2019s cleft cyst. Neurochirurgie. 2021;67(2):104\u2013111."},{"issue":"2","key":"b11","series-title":"Pituitary","first-page":"258","article-title":"A study on clinical outcomes of Rathke\u2019s cleft cyst in patients managed conservatively","volume":"25","author":"Chong GYC","year":"2022","unstructured":"Chong GYC, Tan KCB, Lau EYF, A study on clinical outcomes of Rathke\u2019s cleft cyst in patients managed conservatively. Pituitary. 2022;25(2):258\u2013266."},{"issue":"1","key":"b12","series-title":"Clin Endocrinol (Oxf)","first-page":"54","article-title":"Natural history and surgical outcome of Rathke\u2019s cleft cysts\u2014a study from the Swedish Pituitary Registry","volume":"96","author":"Petersson M","year":"2022","unstructured":"Petersson M, Berinder K, Eden Engstr\u00f6m B, Natural history and surgical outcome of Rathke\u2019s cleft cysts\u2014a study from the Swedish Pituitary Registry. Clin Endocrinol (Oxf). 2022;96(1):54\u201361."},{"issue":"suppl 1","key":"b13","series-title":"Neurol Med Chir (Tokyo)","first-page":"9","article-title":"Brain Tumor Registry of Japan (2005-2008)","volume":"57","year":"2017","unstructured":"Brain Tumor Registry of Japan (2005-2008). Neurol Med Chir (Tokyo). 2017;57(suppl 1):9\u2013102."},{"issue":"4","key":"b14","series-title":"Diagn Interv Imaging","first-page":"209","article-title":"Prevalence of Rathke cleft cysts in children on magnetic resonance imaging","volume":"101","author":"Schmidt B","year":"2020","unstructured":"Schmidt B, Cattin F, Aubry S. Prevalence of Rathke cleft cysts in children on magnetic resonance imaging. Diagn Interv Imaging. 2020;101(4):209\u2013215."},{"issue":"8","key":"b15","series-title":"J Craniofac Surg","first-page":"e791","article-title":"Spontaneous involution of a Rathke cleft cyst","volume":"27","author":"Cheng L","year":"2016","unstructured":"Cheng L, Guo P, Jin P, Li H, Fan M, Cai E. Spontaneous involution of a Rathke cleft cyst. J Craniofac Surg. 2016;27(8):e791\u2013e793."},{"issue":"6","key":"b16","series-title":"J Neurosurg","first-page":"1327","article-title":"Spontaneous involution of Rathke cleft cysts: is it rare or just underreported?","volume":"112","author":"Amhaz HH","year":"2010","unstructured":"Amhaz HH, Chamoun RB, Waguespack SG, Shah K, McCutcheon IE. Spontaneous involution of Rathke cleft cysts: is it rare or just underreported?. J Neurosurg. 2010;112(6):1327\u20131332."},{"issue":"1","key":"b17","series-title":"Neuroradiology","first-page":"27","article-title":"Spontaneous regression of a pituitary cyst","volume":"41","author":"Simmons JD","year":"1999","unstructured":"Simmons JD, Simmons LA. Spontaneous regression of a pituitary cyst. Neuroradiology. 1999;41(1):27\u201329."},{"issue":"8","key":"b18","series-title":"Neurol Med Chir (Tokyo)","first-page":"592","article-title":"Long-term magnetic resonance imaging follow-up of asymptomatic sellar tumors\u2014their natural history and surgical indications","volume":"39","author":"Igarashi T","year":"1999","unstructured":"Igarashi T, Saeki N, Yamaura A. Long-term magnetic resonance imaging follow-up of asymptomatic sellar tumors\u2014their natural history and surgical indications. 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J Neurosurg. 2004;101(4):577\u2013584."},{"issue":"4","key":"b23","series-title":"Acta Neurochir (Wien)","first-page":"853","article-title":"Rathke\u2019s cleft cysts following transsphenoidal surgery: long-term outcomes and development of an optimal follow-up strategy","volume":"162","author":"Marcus HJ","year":"2020","unstructured":"Marcus HJ, Borg A, Hussein Z, Rathke\u2019s cleft cysts following transsphenoidal surgery: long-term outcomes and development of an optimal follow-up strategy. Acta Neurochir (Wien). 2020;162(4):853\u2013861."},{"issue":"3","key":"b24","series-title":"J Neurosurg","first-page":"831","article-title":"Long-term surgical outcomes following transsphenoidal surgery in patients with Rathke\u2019s cleft cysts","volume":"130","author":"Lin M","year":"2018","unstructured":"Lin M, Wedemeyer MA, Bradley D, Long-term surgical outcomes following transsphenoidal surgery in patients with Rathke\u2019s cleft cysts. 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