Clinical features of symptomatic Rathke's cleft cyst

To investigate the clinical features of Rathke's cleft cysts (RCCs), we ret rospectively analyzed 15 cases with histologically confirmed RCCs. All pati ents 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 an d headache. Among the endocrine disturbances based on adenohypophysial dysf unction, hyperprolactinemia was most common. Considering the size of RCCs, RCCs could induce hyperprolactinemia only when the cysts became large enoug h to compress the infundibular-system. Our series showed relative high inci dence of pituitary dwarfism and diabetes insipidus (DI). These facts indica ted that RCCs could evoke hyposecretion of growth hormone in young patients and DI in aged patients by direct compression of the pituitary gland in th e early stage of progression. All cases who had headache had no other sympt oms. We could not prove the evidence that RCCs could induce headaches in th ese cases. This might be suggested that headache could not be a sole sympto m in cases of RCCs. (C) 2001 Elsevier Science B.V. All rights reserved.