title: Rathke's cleft cysts in children and adolescents: association with female puberty.
abstract: There are few pediatric data regarding manifestations and outcomes of Rathke's cleft cysts (RCC). We retrospectively reviewed 13 cases treated at Massachusetts General Hospital over 10 years. Age at presentation was 12-17 years, except for one 7-year-old who presented with sexual precocity. There was a female preponderance [11 females, 2 males, p = 0.01], and all were pubertal at diagnosis. Common features at presentation were headaches (11/13), endocrine abnormalities (5/13) and visual disturbances (2/13). Four patients underwent transsphenoidal surgery. Symptoms improved in all but one, in whom headaches persisted. Recurrent growth in one patient was treated successfully by excision. For conservatively treated patients, cyst size was unchanged over follow-up (6 months-5 years). Female preponderance and pubertal presentation suggest a possible link between sex hormones and RCC pathogenesis. Although estrogen and progesterone receptor immunostaining was negative in the cyst lining, estrogen receptor immunostaining was positive in adjacent pituitary cells. Further investigations regarding this issue are warranted.
authors.affiliation: Pediatric Endocrine Unit, MassGeneral Hospital for Children and Harvard Medical School, USA.
authors.forename: Paravee
authors.initials: P
authors.lastname: Katavetin
authors.forename: Pornsuk
authors.initials: P
authors.lastname: Cheunsuchon
authors.forename: Ellen
authors.initials: E
authors.lastname: Grant
authors.forename: Paul A
authors.initials: PA
authors.lastname: Boepple
authors.forename: E Tessa
authors.initials: ET
authors.lastname: Hedley-Whyte
authors.forename: Madhusmita
authors.initials: M
authors.lastname: Misra
authors.forename: Lynne L
authors.initials: LL
authors.lastname: Levitsky
mesh_terms: D000293:Adolescent; D020863:Central Nervous System Cysts / Q000150:complications / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002648:Child; D004967:Estrogens / Q000502:physiology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D011627:Puberty; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis
chemical_list: D004967:Estrogens; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone