Accurate preoperative diagnosis of a Rathke cleft cyst with the aid of a novel classification for sellar cystic lesions and a diagnostic algorithm decision: Tools for differentiating cystic sellar lesions with a representative case.

Autor:	Cuellar-Hernández JJ; Department of Neurosurgery, Hospital Zambrano Hellion, TecSalud, San Pedro Garza García, Nuevo León, Mexico.; Department of Neurosurgery, National Institute of Pediatrics, Mexico City, Mexico., Ortega-Ruiz OR; Department of Neurosurgery, Hospital Zambrano Hellion, TecSalud, San Pedro Garza García, Nuevo León, Mexico., Rodriguez-Armendariz AG; Department of Neurosurgery, Hospital Zambrano Hellion, TecSalud, San Pedro Garza García, Nuevo León, Mexico., Castillo-Acevedo CD; Department of Neurosurgery, Hospital Zambrano Hellion, TecSalud, San Pedro Garza García, Nuevo León, Mexico., Pérez-Ruano LA; Department of Neurosurgery, Hospital Zambrano Hellion, TecSalud, San Pedro Garza García, Nuevo León, Mexico., Caro-Osorio E; Department of Neurosurgery, Hospital Zambrano Hellion, TecSalud, San Pedro Garza García, Nuevo León, Mexico., Garza-Baez A; Department of Neuro-Radiology, Hospital Zambrano Hellion, TecSalud, San Pedro Garza García, Nuevo León, Mexico.
Jazyk:	angličtina
Zdroj:	Surgical neurology international [Surg Neurol Int] 2024 Apr 05; Vol. 15, pp. 120. Date of Electronic Publication: 2024 Apr 05 (Print Publication: 2024).
DOI:	10.25259/SNI_59_2024
Abstrakt:	Background: Rathke's cleft cyst (RCC) is a benign lesion in the sellar and suprasellar compartments. Similarly, pituitary adenomas can present with cystic morphology, making it a differential diagnosis when evaluating a patient with a cystic lesion in the sellar region. Surgical goals differ between RCCs and pituitary adenomas as the first can achieve remission of symptoms with cyst decompression in contrast to pituitary adenomas where complete resection would be the main goal. Imaging analysis alone may not be sufficient to define a preoperative surgical plan. The combination of imaging and conjoined use of validated tools may provide valuable insights to the clinician when defining a surgical approach. Case Description: We present a case of a 27-year-old male with a 3-month history of visual disturbances and headaches. Magnetic resonance imaging showed a cystic lesion in the sellar compartment with compression of nearby structures. The authors were able to accurately diagnose this sellar lesion as an RCC with the conjoined aid of two classifications proposed in the literature. Cyst evacuation was performed with relief of symptoms and improved visual outcomes at follow-up. Conclusion: While cystic adenomas can require total resection for cure, RCCs can show marked improvement with partial resection and evacuation of its contents. An accurate preoperative diagnosis can lead the surgeon to opt for the best surgical approach. Competing Interests: There are no conflicts of interest. (Copyright: © 2024 Surgical Neurology International.)
Databáze:	MEDLINE
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