Rathke's cyst with xanthogranulomatous change or chronic cystic craniopharingioma? A rare case.

Autor: Gaggero G; Pathology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy., Vitulli F; Neurosurgery Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. vitullifrancesca@gmail.com.; Department of Neurosciences and Reproductive and Dental Sciences, Division of Neurosurgery, Federico II' University of Naples, Naples, Italy. vitullifrancesca@gmail.com., Ramaglia A; Services Department, Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy., Antico A; Neurosurgery Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.; Department of Neuroscience Rita Levi Montalcini, Neurosurgery Unit, University of Turin, Turin, Italy., Canevari FR; Dipartimento 1 DISC, Otorhinolaryngology Unit, IRCCS Policlinico San Martino Genova, Università di Genova, 16124, Genoa, Italy., Piatelli G; Neurosurgery Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy., Criminelli Rossi D; Department of Neurosciences (DINOGMI), Neurosurgery Unit, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
Jazyk: angličtina
Zdroj: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2024 Apr; Vol. 40 (4), pp. 1311-1314. Date of Electronic Publication: 2024 Jan 13.
DOI: 10.1007/s00381-024-06288-w
Abstrakt: A 9-year-old girl presented to our neurosurgery clinic complaining of visual disturbances for a week. Magnetic resonance imaging showed an extensive sellar lesion with suprasellar involvement and compression of the optic chiasm. Based on these findings, a cystic craniopharyngioma, a pituitary macroadenoma and - less likely - a Rathke's cleft cyst were considered as differential diagnoses. In view of the progressive loss of vision, the parents agreed to resection of the lesion through an endoscopic endonasal transtubercular approach, with the aim of a gross total resection. Microscopic examination revealed that the lesion was cystic, surrounded by an epithelium that was partly composed of columnar ciliated cells with interspersed mucous cells and partly had a flattened appearance. The observed findings were complex to interpret: if, on the one hand, the clinical-surgical and neuroradiologic data suggested a craniopharyngioma, this hypothesis was not supported by the microscopic data, because the presence of columnar ciliated epithelium associated with mucous cells was a microscopic feature inconsistent with a craniopharyngioma and was instead consistent with a Rathke's cleft cyst, a histologic diagnosis that was made. The incidence of Rathke's cleft cyst, which mimics clinical and neuroradiologic aspects of craniopharyngiomas, is extremely unusual, as only 2 cases have been described in the literature.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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