A case of Cushing's disease accompanied by Rathke's cleft cyst: the usefulness of cavernous sinus sampling in the localization of microadenoma.
A 42-year-old man presented with classical symptoms of Cushing's disease. Endocrinological examinations indicated the presence of a adrenocorticotropin-(ACTH) producing pituitary adenoma. Magnetic resonance imaging showed a cystic sellar lesion, which had features of a Rathke's cleft cyst, whereas the adenoma was not depicted. The ratio of blood ACTH concentration between cubital vein, left, and right cavernous sinus was 1: 1.4: 20. During transsphenoidal surgery, in addition to the Rathke's left cyst, a tiny adenoma was detected beneath the left pituitary lobe. Cavernous sinus sampling is a useful auxiliary in the localization of an ACTH-producing adenoma, as in this case.
Arita
K
K
Department of Neurosurgery, Hiroshima University School of Medicine, Japan.
Uozumi
T
T
Takechi
A
A
Hirohata
T
T
Pant
B
B
Kubo
K
K
Tanaka
K
K
D000236:Adenoma / Q000097:blood* / Q000150:complications; D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D002426:Cavernous Sinus; D003397:Craniopharyngioma / Q000097:blood* / Q000150:complications; D003480:Cushing Syndrome / Q000097:blood* / Q000209:etiology; D006801:Humans; D008297:Male; D017591:Petrosal Sinus Sampling / Q000379:methods; D010911:Pituitary Neoplasms / Q000097:blood* / Q000150:complications
D000324:Adrenocorticotropic Hormone