{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:52:35Z","timestamp":1777661555138,"version":"3.51.4"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Rathke\u2019s cleft cyst (RCC) is the most commonly encountered pituitary incidentaloma in children. Because RCC is not frequently diagnosed in children, there are few reports on pediatric RCCs. The natural course of the disease and appropriate treatments are still obscure. The present study aimed to elucidate the natural history and surgical indications of RCCs in children.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors retrospectively reviewed the clinical presentations, imaging features, ophthalmological evaluations, endocrine evaluations, and surgical outcomes of pediatric RCCs at a single institution from January 2000 to October 2022. Clinical outcomes between the surgery and observation groups were compared.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Among 93 patients, there were 41 patients in the surgery group and 52 patients in the observation group. The mean age at diagnosis was 10.9 years, and the mean follow-up period was 5.6 years. Headache fully or partially improved after surgery (86.2%), but the rate of improvement was not different from that of the observation group (70.0%). Ophthalmological abnormalities were effectively improved by surgical treatment (93.3%). Both the improvement and deterioration rates of endocrine abnormalities were significantly higher in the surgery group (p = 0.026 and p &lt; 0.001, respectively), but the deterioration rate (43.9%) was higher than the improvement rate (14.6%). In the surgery group, the recurrence rate was 17.1% and the reoperation rate was 4.9%. Compared with total cyst wall resection, cyst fenestration with partial wall resection was associated with a higher recurrence rate (26.9%, p = 0.035) but a lower rate of endocrine abnormalities (30.8%, p = 0.049).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Pediatric RCCs of \u2265 10 mm in size were analyzed. Ophthalmological abnormalities are the major surgical indications for pediatric RCCs. Headache and partial endocrine abnormalities may be improved with surgery, but they are not absolute indications for surgery. Cyst fenestration with partial wall resection via an endoscopic endonasal approach is the most recommended surgical method. Follow-up is essential to monitor for the occurrence of visual field defects and the recurrence of cysts.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.7.peds23181","type":"journal-article","created":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T05:13:05Z","timestamp":1693631585000},"page":"729-738","source":"Crossref","is-referenced-by-count":5,"title":["Surgical indication of pediatric Rathke\u2019s cleft cyst based on a 20-year retrospective cohort"],"prefix":"10.3171","volume":"32","author":[{"given":"Jong Seok","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurosurgery, Pediatric Clinical Neuroscience Center, Seoul National University Children\u2019s Hospital, Seoul;"},{"name":"Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong Hwy","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun Jung","family":"Koh","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Pediatric Clinical Neuroscience Center, Seoul National University Children\u2019s Hospital, Seoul;"},{"name":"Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Hoon","family":"Phi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Pediatric Clinical Neuroscience Center, Seoul National University Children\u2019s Hospital, Seoul;"},{"name":"Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul;"},{"name":"Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Yeoun","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Pediatric Clinical Neuroscience Center, Seoul National University Children\u2019s Hospital, Seoul;"},{"name":"Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul;"},{"name":"Department of Anatomy and Cell Biology, Neural Development and Anomaly Laboratory, Seoul National University College of Medicine, Seoul;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Pediatric Clinical Neuroscience Center, Seoul National University Children\u2019s Hospital, Seoul;"},{"name":"Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyu-Chang","family":"Wang","sequence":"additional","affiliation":[{"name":"Neuro-Oncology Clinic, Center for Rare Cancers, National Cancer Center, Goyang;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung-Eun","family":"Cheon","sequence":"additional","affiliation":[{"name":"Division of Pediatric Radiology, Seoul National University Children\u2019s Hospital, Seoul National University College of Medicine, Seoul;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung-Hye","family":"Park","sequence":"additional","affiliation":[{"name":"Departments of Pathology and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Ah","family":"Lee","sequence":"additional","affiliation":[{"name":"Pediatrics, Seoul National University Children\u2019s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Choong Ho","family":"Shin","sequence":"additional","affiliation":[{"name":"Pediatrics, Seoul National University Children\u2019s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung-Ki","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Pediatric Clinical Neuroscience Center, Seoul National University Children\u2019s Hospital, Seoul;"},{"name":"Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","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 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