title: Clinical and radiological findings of incidental Rathke's cleft cysts in children and adolescents.
abstract: OBJECTIVE
  In the pediatric population, Rathke's cleft cysts (RCCs) are known to be an infrequent cause of headaches, visual disturbances, and pituitary dysfunction. We investigated the clinical characteristics of children in whom RCCs were incidentally discovered and evaluated whether RCCs influence the treatment response of patients with proven endocrinopathy.
  
  
  METHODS
  A retrospective analysis was conducted in 34 patients with RCCs who were diagnosed between 2006 and 2013 at Hallym University Medical Center. Their clinical, hormonal, and imaging findings were reviewed. We evaluated the clinical outcomes of the patients with concomitant RCCs and endocrinopathy compared to matched controls.
  
  
  RESULTS
  Twenty-six of 34 patients with radiologically proven RCCs had endocrine disorders. They were 9 boys and 17 girls, with ages ranging from 4.8 to 17.4 years at the time of the diagnosis. Of these, 7 (27%) had idiopathic short stature, 7 (27%) had growth hormone deficiency (GHD), and 12 (46%) had central precocious puberty (CPP). Nineteen of 26 patients (73.1%) showed low signal intensities on T1-weighted images (T1WI) and high signal intensities on T2-weighted images. The incidence of hypointensity on T1WI was higher in the patients with RCCs accompanied by endocrinopathy than in those without endocrinopathy (P=0.033). The treatment outcomes of the patients with CPP and GHD with and without RCCs were similar.
  
  
  CONCLUSIONS
  CPP and GHD patients with a small RCC (less than 20 mm) expressing cystic magnetic resonance intensity can be managed with medical treatment, although the RCCs need to be closely monitored in radiological studies to observe their growth.
authors.affiliation: Department of Pediatrics, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Yeon Joung
authors.initials: YJ
authors.lastname: Oh
authors.affiliation: Department of Pediatrics, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Hong Kyu
authors.initials: HK
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Seung
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Song
authors.affiliation: Department of Pediatrics, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Il Tae
authors.initials: IT
authors.lastname: Hwang
keywords: Central; Central nervous system cysts; Pituitary dwarfism; Precocious puberty