Reduction in Size of a Large Rathke's Cleft Cyst on Treatment with Low Dose of Corticosteroid.
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.
Furtado
S V
SV
Department of Neurosurgery, Sri Satya Sai Institute of Higher Medical Sciences, Bangalore, India.
Venkatesh
P K
PK
Ghosal
N
N
Hedge
A S
AS
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D020863:Central Nervous System Cysts / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D009423:Nervous System Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery; D013963:Thyroid Hormones / Q000378:metabolism; D047368:Tumor Burden / Q000187:drug effects
D000305:Adrenal Cortex Hormones; D013963:Thyroid Hormones