Rathke囊肿的临床特点及治疗前后垂体功能改变

Preliminary study of the clinical features and pituitary dysfunction in patients with Rathke′s cleft cysts

  • 摘要: 目的:总结Rathke囊肿(RCC)的临床特点及治疗前后内分泌功能改变。方法:回顾性分析我院1998年9月-2006年9月收治并经手术和病理证实的65例症状性RCC患者的临床、影像特点及治疗前后内分泌功能改变。结果:1)女性多见,男:女=1∶3.4,术前误诊率高;2)最常见的临床表现为头痛、头晕,其次为视力减退和/或视野缺损;3)MR I影像学表现多样,T1可表现为低、等、高信号,T2多呈高信号;4)58.6%患者术前存在垂体功能紊乱,以垂体-性腺激素分泌受损最常见,严重者可发生全垂体功能减退甚至危象;5)手术治疗可有效改善受损的垂体功能,少数可因并发症导致部分垂体功能受损。结论:RCC临床、影像表现多样,术前误诊率高,常有垂体功能紊乱;外科治疗效果好,临床医生应重视RCC手术前后垂体功能的评价。

     

    Abstract: Objective: To investigate the clinical features and pituitary dysfunction in patients with Rathke's cleft cyst(RCC).Methods: A retrospective study of 65 patients with RCC diagnosed and treated in our hospital between 1998 and 2006 was conducted.Results: The RCC was more often seen in female(F:M=1∶3.4) and misdiagnosed before operation.Most of the patients with RCC had various degrees of pituitary dysfunction.Headache and visual disturbance were the common clinical presentations in patients with RCC.The plain scanning of MRI of the most cysts showed hypointense or evenintense or hyperintense on T1-weighted imaging while hyperintense on T2-weighted imaging.Secondary hypogonadotrophin was the most prevalent abnormalities,and the most prevalent symptoms in male RCC patients were impotence or diminished libido and in female were menstrual disorder and galactorrhea.The panhypopituitarism was also appeared in few patients with RCC.Conclusion: Rathke's cleft cysts is a rare pathology with a wide spectrum of clinical and radiological features.The incidence of endocrinological dysfunction in patients with RCC is higher than suspected.The patients can benefit from operation and more attention should be paid to the new onset of pituitary dysfunction.All the patients need to undergo systematic endocrinological evaluations before and after operation.

     

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