Isono M, Kamida T, Kobayashi H, Shimomura T, Matsuyama J
Department of Neurosurgery, Oita Medical University, 1-1, Idaigaoka, Hasama-machi, Oita 879-5593, Japan.
Clin Neurol Neurosurg. 2001 Jul;103(2):96-100. doi: 10.1016/s0303-8467(01)00121-4.
To investigate the clinical features of Rathke's cleft cysts (RCCs), we retrospectively analyzed 15 cases with histologically confirmed RCCs. All patients underwent formal testing of visual field, endocrinological evaluation and magnetic resonance imagings. As overall presenting symptoms, endocrine disturbance was the most common symptoms, followed by visual disturbance and headache. Among the endocrine disturbances based on adenohypophysial dysfunction, hyperprolactinemia was most common. Considering the size of RCCs, RCCs could induce hyperprolactinemia only when the cysts became large enough to compress the infundibular system. Our series showed relative high incidence of pituitary dwarfism and diabetes insipidus (DI). These facts indicated that RCCs could evoke hyposecretion of growth hormone in young patients and DI in aged patients by direct compression of the pituitary gland in the early stage of progression. All cases who had headache had no other symptoms. We could not prove the evidence that RCCs could induce headaches in these cases. This might be suggested that headache could not be a sole symptom in cases of RCCs.
为了研究拉克氏囊肿（RCCs）的临床特征，我们回顾性分析了15例经组织学确诊为RCCs的病例。所有患者均接受了正规的视野检查、内分泌评估和磁共振成像检查。作为总体表现症状，内分泌紊乱是最常见的症状，其次是视觉障碍和头痛。在基于腺垂体功能障碍的内分泌紊乱中，高催乳素血症最为常见。考虑到RCCs的大小，只有当囊肿足够大到压迫漏斗系统时，RCCs才会诱发高催乳素血症。我们的系列研究显示垂体性侏儒症和尿崩症（DI）的发病率相对较高。这些事实表明，在疾病进展早期，RCCs可通过直接压迫垂体，导致年轻患者生长激素分泌不足，老年患者出现尿崩症。所有有头痛症状的病例均无其他症状。在这些病例中，我们无法证明RCCs可诱发头痛的证据。这可能提示头痛并非RCCs病例的唯一症状。
