Artikel
Xanthogranulomas, Rathke’s cleft cysts and colloid cysts – epithelial lesions of the sellar region – clinical and endocrinological features after surgery in a single-centre cohort
Xanthogranulome, Rathke Zysten und Kolloidzysten – Epitheliale Läsionen der Sella-Region – klinische und endokrinologische Charakteristika nach neurochirurgischer Operation in einem Single-Center-Kollektiv
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Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: Epithelial lesions of the sellar region are rare. Treatment can be challenging as outcome may be poor due to neurological or endocrinological dysfunction. While there are serveral studies summarizing the clinical and postoperative experience of craniopharyngiomas, there is no systematic report on patients with xanthogranulomas, Rathke’s cleft cysts and colloid cysts. Therefore we aim to investigate the neurological and endocrinological outcome in our cohort.
Methods: A retrospective cohort analysis was performed on 345 patients with sella pathology who underwent surgery between 2007–2018. To determine the clinical outcome, ophthalmological and endocrine evaluations were performed prior and after surgery. Postoperative data such as complications, endocrinological dysfunction and recurrence rate were collected. Median follow-up was 16 months.
Results: Among 19/345 patients (5,5%) who underwent surgery histopathological investigation revealed the presence of 8 xanthogranulomas, 7 Rathke’s cleft cysts and 4 colloid cysts. Prior to surgery chiasmal syndrome was present in 8/19 patients, 5/19 patients showed corticotropin deficiency and 3/19 patients gonadotropin deficiency. 18 patients received transsphenoidal surgery, 1 patient via ventriculostomy. After surgery visual acuity improved in 8 cases (100%), gonadal axis improved in all female patients while corticotropin deficiency rarely recovered (20%). 2 patients showed recurrence and underwent repeat surgery.
Conclusion: This study provides a detailed description of the postoperative features of these rare lesions in a well-defined cohort of patients. We provide the first systematic review on these epithelial lesions of the sellar region after surgery by taking neurological and endocrine features into account. Patients can present with severe neurological and endocrinological disorders. Surgery provides recovery of the preoperative deficits and favourable outcome especially of visual acuity. With this study we want to draw attention to these rare lesions.