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DOI: 10.1055/s-0029-1243248
© Georg Thieme Verlag KG Stuttgart · New York
Reduction in Size of a Large Rathke's Cleft Cyst on Treatment with Low Dose of Corticosteroid
Publikationsverlauf
received 21.09.2009
accepted 17.11.2009
Publikationsdatum:
14. Dezember 2009 (online)
Abstract
Rathke's cleft cyst is a non-neoplastic sellar cyst, which is increasingly reported on radiological investigation performed for unrelated intra-cranial pathology. When symptomatic, it is associated with headache, visual symptoms, and pituitary dysfunction. We report a case of an 18 year-old male patient with Rathke's cleft cyst, who presented with failing vision, headache, and hypocortisolism. After defaulting on planned surgery, the patient continued to take a replacement dose of prednisolone for a year. He reported significant improvement in vision and remarkable reduction in cyst size on repeat imaging after a year. Surgery was later performed in view of persisting severe headache. The authors discuss the reduction in cyst size in relation to long-term usage of replacement steroid. They postulate that selected patients with Rathke's cleft cyst with radiological evidence of inflammatory fluid can be given a trial of glucocorticoids and assessed for cyst shrinkage and changes in imaging characteristics.
Key words
glucocorticoid - headache - inflammation - mucin - Rathke's cleft cyst - surgery
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Correspondence
Dr. Sunil V. Furtado
Department of Neurosurgery
SSSIHMS
EPIP Area
Whitefield
560066 Bangalore
India
Telefon: +91/80/2841 6837
Fax: +91/80/2841 1503
eMail: sunilvf@gmail.com