Tanaka S, Yanase T, Takayanagi R, Haji M, Nawata H
Third Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Nihon Naibunpi Gakkai Zasshi. 1994 Aug 20;70(6):555-62. doi: 10.1507/endocrine1927.70.6_555.
A 41-year-old man was admitted to our hospital because of general fatigue, sexual debility and finger stiffness. Endocrinological examinations revealed that he had panhypopituitarism, resulting in secondary adrenal insufficiency, hypothyroidism and gonadal failure. Computed tomography (CT) of the head demonstrated a low density intrasellar mass, while brain magnetic resonance imaging (MRI) showed a high intensity mass extending from the intrasellar to suprasellar region in both T1WI and T2WI. The mass was removed by transsphenoidal surgery and histologically diagnosed as Rathke's cleft cyst. Replacement with hydrocortisone and levothyroxine sodium greatly improved the clinical symptoms. Rathke's cleft cyst causing panhypopituitarism is relatively rare. The clinical and endocrinological characteristics of Rathke's cleft cyst were discussed based on the findings in 49 Japanese cases including this case and two other cases we have experienced.
一名41岁男性因全身乏力、性功能减退和手指僵硬入院。内分泌检查发现他患有全垂体功能减退症，导致继发性肾上腺皮质功能不全、甲状腺功能减退和性腺功能衰竭。头部计算机断层扫描（CT）显示鞍内低密度肿块，而脑部磁共振成像（MRI）在T1加权像（T1WI）和T2加权像（T2WI）上均显示从鞍内延伸至鞍上区域的高强度肿块。该肿块通过经蝶窦手术切除，组织学诊断为拉克氏囊肿。氢化可的松和左甲状腺素钠替代治疗使临床症状得到显著改善。导致全垂体功能减退症的拉克氏囊肿相对罕见。基于包括本病例以及我们所经历的另外两例在内的49例日本病例的研究结果，对拉克氏囊肿的临床和内分泌特征进行了讨论。
