title: A Case of Rathke's Cleft Cyst Associated with Transient Central Adrenal Insufficiency and Masked Diabetes Insipidus.
abstract: A 73-year-old woman admitted to our hospital because of headache, poor appetite, malaise, weight loss, and vomiting was found to have central adrenal insufficiency and thyrotoxicosis due to silent thyroiditis. Polyuria developed after replacement with glucocorticoid (masked diabetes insipidus), which was controlled with nasal administration of desmopressin. Magnetic resonance imaging of the brain showed a large cystic pituitary mass (18 × 18 × 12 mm) extending suprasellarly to the optic chiasm. Transsphenoidal surgery revealed that the pituitary tumor was Rathke's cleft cyst. Following surgery, replacement with neither glucocorticoid nor desmopressin was needed any more. Therefore, it is suggested that Rathke's cleft cyst is responsible for the masked diabetes insipidus and the central insufficiency. Furthermore, it is speculated that thyrotoxicosis with painless thyroiditis might induce changes from subclinical adrenal insufficiency to transiently overt insufficiency.
authors.affiliation: Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan.
authors.forename: Masahiro
authors.identifier: 0000-0001-8623-9941
authors.initials: M
authors.lastname: Asakawa
authors.affiliation: Department of Endocrinology and Metabolism, Tokyo Kyosai Hospital, 2-3-8, Nakameguro, Meguro-ku, Tokyo 153-0061, Japan.
authors.forename: Rina
authors.initials: R
authors.lastname: Chin
authors.affiliation: Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Niitsu
authors.affiliation: Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Sekine
authors.affiliation: Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan.
authors.forename: Arisa
authors.initials: A
authors.lastname: Niwa
authors.affiliation: Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan.
authors.forename: Atsuko
authors.identifier: 0000-0001-8359-8797
authors.initials: A
authors.lastname: Miyake
authors.affiliation: Department of Pathology, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo 105-0001, Japan.
authors.forename: Naoko
authors.identifier: 0000-0002-5459-3388
authors.initials: N
authors.lastname: Inoshita
authors.affiliation: Department of Endocrinology and Metabolism, Tokyo Teishin Hospital, 2-14-23, Fujimi, Chiyoda-ku, Tokyo 102-0071, Japan.
authors.forename: Mitsunobu
authors.identifier: 0000-0002-3957-0372
authors.initials: M
authors.lastname: Kawamura
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Tokyo Medical and Dental University Hospital, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Institute of Biochemical Research and Innovation Hospital, 2-2 Minatoshima-Minamicho, Chuo-ku, Kobe, Hyogo 650-0047, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Hirata