Long-term endocrine outcome of suprasellar arachnoid cysts.
OBJECTIVE Due to their distinct location, suprasellar arachnoid cysts are known to cause a wide variety of problems, such as hydrocephalus, endocrine symptoms, and visual abnormalities. The long-term outcome of these cysts has not been elucidated. To find out the long-term outcome of suprasellar arachnoid cysts, a retrospective review of the patients was performed. The neurological and endocrine symptoms were thoroughly reviewed. METHODS Forty-five patients with suprasellar arachnoid cysts, with an average follow-up duration of 9.7 years, were enrolled in the study. A comprehensive review was performed of the results of follow-up regarding not only neurological symptoms but also endocrine status. The outcomes of 8 patients who did not undergo operations and were asymptomatic or had symptoms unrelated to the cyst were included in the series. RESULTS Surgery was most effective for the symptoms related to hydrocephalus (improvement in 32 of 32), but endocrine symptoms persisted after surgery (4 of 4) and required further medical management. More surprisingly, a fairly large number of patients (14 of 40; 1 was excluded because no pre- or postoperative endocrine evaluation was available) who had not shown endocrine symptoms at the time of the initial diagnosis and treatment later developed endocrine abnormalities such as precocious puberty and growth hormone deficiency. The patients with endocrine symptoms detected during the follow-up included those in both the operated (n = 12 of 32) and nonoperated (n = 2 of 8) groups who had been stable during follow-up since the initial diagnosis. CONCLUSIONS This study implies that patients with suprasellar arachnoid cysts can develop late endocrine problems during follow-up, even if other symptoms related to the cyst have been successfully treated. Hence, patients with these cysts need long-term follow-up for not only neurological symptoms but also endocrine abnormalities.
Department of Anatomy and Cell Biology, Seoul National University College of Medicine; and.|Division of Pediatric Neurosurgery.
Ji Yeoun
JY
Lee
Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
Young Ah
YA
Lee
Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
Hae Woon
HW
Jung
Division of Pediatric Neurosurgery.
Sangjoon
S
Chong
Division of Pediatric Neurosurgery.
Ji Hoon
JH
Phi
Division of Pediatric Neurosurgery.
Seung-Ki
SK
Kim
Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
Choong-Ho
CH
Shin
Division of Pediatric Neurosurgery.
Kyu-Chang
KC
Wang
D000293:Adolescent; D016080:Arachnoid Cysts / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004700:Endocrine System Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
ACTH = adrenocorticotropic hormone; CPS = cystoperitoneal shunting; GH = growth hormone; GnRH = gonadotropin-releasing hormone; VPS = ventriculoperitoneal shunting; arachnoid cyst; congenital; endocrine outcome; hormone; suprasellar