Department of Neurosurgery, Erzincan Binali Yildirim University School of Medicine, Erzincan, Turkey.
Department of Neurosurgery, Okmeydani Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
World Neurosurg. 2019 Aug;128:e522-e530. doi: 10.1016/j.wneu.2019.04.188. Epub 2019 Apr 30.
Rathke's cleft cysts (RCCs) may have various anatomic, clinical, and radiologic characteristics, which may be related to their differences in texture or consistency. The purpose of the study was to investigate RCCs based on consistency.
We retrospectively reviewed 25 cases of patients with RCCs who underwent endoscopic endonasal transsphenoidal surgery between 2008 and 2018. Cases were divided into 3 types based on cyst consistency: fluid (serous) or type A (n = 4); semi-fluid (mucoid) or type B (n = 17); and non-fluid (caseous) or type C (n = 4). Demographic, clinical, radiologic, and surgical characteristics for each group were analyzed.
All type A RCCs (100%) had visual impairment. The mean age (42.8 ± 13 years) and cyst volume (2442.5 ± 533.6 mm) were higher in these patients. T1-weighted images were hypointense and T2-weighted images were hyperintense on magnetic resonance imaging. Type B RCCs were more frequently encountered (68%). Although headache was the most common (82.3%) symptom, endocrine disorders were also prevalent (52.9%). T1-weighted images were typically isointense or hyperintense on magnetic resonance imaging. Type C RCCs had the youngest patient population (30.3 ± 10.2 years) and T2-weighted images were predominantly hypointense in this group.
The proposed novel consistency classification of RCCs will provide a practical tool for more accurately estimating the nature of the pathology, because each type has its own specific characteristics. Furthermore, the new classification of RCCs may aid in planning a consistency-specific surgery.
拉氏裂囊肿（RCC）可能具有各种解剖、临床和放射学特征，这些特征可能与其质地或一致性的差异有关。本研究的目的是根据一致性对 RCC 进行研究。
我们回顾性分析了 2008 年至 2018 年间接受经鼻内镜蝶窦手术的 25 例 RCC 患者。根据囊肿的一致性将病例分为 3 型：液体（浆液性）或 A 型（n=4）；半液体（黏液性）或 B 型（n=17）；非液体（乳酪状）或 C 型（n=4）。分析各组的人口统计学、临床、影像学和手术特征。
所有 A 型 RCC（100%）均有视力障碍。这些患者的平均年龄（42.8±13 岁）和囊肿体积（2442.5±533.6mm）较高。磁共振成像上 T1 加权像呈低信号，T2 加权像呈高信号。B 型 RCC 更为常见（68%）。虽然头痛是最常见的（82.3%）症状，但内分泌紊乱也很常见（52.9%）。磁共振成像上 T1 加权像通常为等信号或高信号。C 型 RCC 患者的年龄最小（30.3±10.2 岁），该组 T2 加权像主要呈低信号。
提出的 RCC 新的一致性分类将为更准确地估计病理性质提供一个实用的工具，因为每种类型都有其自身的特定特征。此外，RCC 的新分类可能有助于计划针对一致性的手术。
