{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:27:13Z","timestamp":1789165633546,"version":"build-2803163510"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,2]]},"abstract":"<jats:p content-type=\"fine-print\">\n                    <jats:italic>Object.<\/jats:italic>\n                    Microscopic Rathke cleft cysts are a common incidental autopsy finding, but some Rathke cleft cysts can become sufficiently large to cause visual impairment, hypothalamic\u2014pituitary dysfunction, and headaches. In this study patients were evaluated pre- and postoperatively to ascertain the clinical significance of surgical intervention on endocrine and visual improvement. Factors correlated with cyst recurrence were also evaluated.\n                  <\/jats:p>\n                  <jats:p content-type=\"fine-print\">\n                    <jats:italic>Methods.<\/jats:italic>\n                    A retrospective analysis was conducted in 160 patients with Rathke cleft cysts who were treated between 1984 and 1995 and completed at least a 5-year follow-up period. Of these 160 patients, 118 initially exhibited symptoms of visual impairment or endocrine dysfunction, became symptomatic during the follow-up period, or were found to have cyst enlargement. These 118 patients underwent transsphenoidal surgery. Forty-two patients with incidental lesions that demonstrated no growth on magnetic resonance (MR) images were followed up without an operation.\n                  <\/jats:p>\n                  <jats:p content-type=\"fine-print\">Complete resection, as observed on MR images 3 months postoperatively, was obtained in 114 (97%) of 118 patients. Vision improved postoperatively in 57 (98%) of 58 patients. Hypogonadism improved in 11 (18%) of 62 patients, growth hormone deficiency resolved in 14 (18%) of 78 patients, and hypocortisolemia resolved in one (14%) of seven patients. Twenty-two patients (19%) began to exhibit symptoms of diabetes insipidus, which had not been present preoperatively. The total 5-year recurrence rate was 18% (21 of 118 patients), with 12 patients requiring a repeated operation. Surgical and pathological factors that were found to be statistically associated with recurrence were the use of a fat and\/or fascial graft for closure (p &lt; 0.01) and the presence of squamous metaplasia in the cyst wall (p &lt; 0.01). The extent of resection of the cyst wall was not associated with an increased rate of recurrence. In 42 (69%) of 61 patients the incidental cysts did not progress on imaging studies or clinically.<\/jats:p>\n                  <jats:p content-type=\"fine-print\">\n                    <jats:italic>Conclusions.<\/jats:italic>\n                    This is the largest series of patients with symptomatic Rathke cleft cysts who received operative intervention and participated in the longest postoperative follow up reported in the literature. The high recurrence rate (18%) supports the theory that a relationship exists between a symptomatic Rathke cleft cyst and craniopharyngioma. Improvements in visual and endocrine dysfunction can be expected after surgical decompression of the optic apparatus and the hypothalamic\u2014pituitary axis.\n                  <\/jats:p>","DOI":"10.3171\/jns.2005.102.2.0189","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T14:11:07Z","timestamp":1242223867000},"page":"189-193","source":"Crossref","is-referenced-by-count":199,"title":["Surgical outcomes in 118 patients with Rathke cleft cysts"],"prefix":"10.3171","volume":"102","author":[{"given":"Christopher J.","family":"Aho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Zelman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T.","family":"Couldwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin H.","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"8","DOI":"10.3171\/jns.1984.60.1.0008","article-title":"Transsphenoidal treatment of non-neoplastic intrasellar cysts. A report of 38 cases.","volume":"60","author":"Baskin","year":"1984"},{"key":"b2","series-title":"Surgical Pathology of the Nervous System and Its Coverings","author":"Burger","year":"2002"},{"key":"b3","series-title":"Surgery of the Third Ventricle","first-page":"553","article-title":"The transnasal transsphenoidal approach","author":"Couldwell","year":"1998"},{"key":"b4","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1097\/00006123-199801000-00003","article-title":"Transsphenoidal management of 28 symptomatic Rathke's cleft cysts, with special reference to visual and hormonal recovery.","volume":"42","author":"El-Mahdy","year":"1998"},{"key":"b5","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"77","DOI":"10.3171\/jns.1966.24.1.0077","article-title":"Intrasellar epithelial cysts.","volume":"24","author":"Fager","year":"1966"},{"key":"b6","series-title":"J Neurosurg","doi-asserted-by":"publisher","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":"Harrison","year":"1994"},{"key":"b7","series-title":"J Neuropathol Exp Neurol","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1097\/00005072-197404000-00009","article-title":"The fine structure of colloid cysts of the third ventricle.","volume":"33","author":"Hirano","year":"1974"},{"key":"b8","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.3171\/jns.2004.100.6.1087","article-title":"Devastating complications from alcohol cauterization of recurrent Rathke cleft cyst. Case report.","volume":"100","author":"Hsu","year":"2004"},{"key":"b9","series-title":"Clin Neuropathol","first-page":"82","article-title":"Clinicopathological study of Rathke's cleft cysts.","volume":"21","author":"Ikeda","year":"2002"},{"key":"b10","series-title":"Ann Ophthalmol","first-page":"94","article-title":"Ocular involvement in recurrent cyst of Rathke's cleft: case report.","volume":"11","author":"Iraci","year":"1979"},{"key":"b11","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/S0303-8467(01)00121-4","article-title":"Clinical features of symptomatic Rathke's cleft cyst.","volume":"103","author":"Isono","year":"2001"},{"key":"b12","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"33","DOI":"10.3171\/jns.2004.100.1.0033","article-title":"Surgical treatment of symptomatic Rathke cleft cysts: clinical features and results with special attention to recurrence.","volume":"100","author":"Kim","year":"2004"},{"key":"b13","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/0090-3019(95)00144-1","article-title":"The pathological, surgical, and MR spectrum of Rathke cleft cysts.","volume":"44","author":"Kleinschmidt-Demasters","year":"1995"},{"key":"b14","series-title":"Acta Neuropathol","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/BF00688754","article-title":"Ciliated and goblet cells in craniopharyngioma. Light and electron microscopic studies at surgery and autopsy.","volume":"50","author":"Matsushima","year":"1980"},{"key":"b15","series-title":"J Clin Endocrinol Metab","first-page":"2357","article-title":"Clinical, radiological and pathological features of patients with Rathke's cleft cyst: tumors that may recur.","volume":"82","author":"Mukherjee","year":"1997"},{"key":"b16","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"703","DOI":"10.3171\/jns.1961.18.5.0703","article-title":"Pituitary cyst of Rathke's cleft origin with hypopituitarism.","volume":"18","author":"Naiken","year":"1961"},{"key":"b17","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1227\/00006123-199202000-00004","article-title":"Radiologic characteristics and results of surgical management of Rathke's cleft cysts in 43 patients.","volume":"30","author":"Ross","year":"1992"},{"key":"b18","series-title":"Eur J Endocrinol","first-page":"123","article-title":"A survey of pituitary incidentaloma in Japan.","volume":"149","author":"Sanno","year":"2003"},{"key":"b19","series-title":"Acta Anat","first-page":"361","article-title":"The incidence and distribution of cilia in the human pituitary with a description of microfollicular cysts derived from Rathke's cleft.","volume":"11","author":"Shanklin","year":"1951"},{"key":"b20","series-title":"J Clin Endocrinol Metab","first-page":"3972","article-title":"Cystic lesions of the pituitary: clinicopathological features distinguishing craniopharyngioma, Rathke's cleft cyst, and arachnoid cyst.","volume":"84","author":"Shin","year":"1999"},{"key":"b21","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"535","DOI":"10.3171\/jns.1991.74.4.0535","article-title":"Clinical, radiographic, and pathological features of symptomatic Rathke's cleft cysts.","volume":"74","author":"Voelker","year":"1991"},{"key":"b22","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"3","DOI":"10.3171\/jns.1990.73.1.0003","article-title":"Total removal of craniopharyngiomas. Approaches and long-term results in 144 patients.","volume":"73","author":"Ya\u015fargil","year":"1990"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/102\/2\/article-p189.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/102\/2\/article-p189.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/102\/2\/article-p189.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,3]],"date-time":"2022-07-03T09:39:48Z","timestamp":1656841188000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/102\/2\/article-p189.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,2]]},"references-count":22,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/jns.2005.102.2.0189","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[2005,2]]}}}