Page 17 - HKSEMR2020 Programme book

Oral Presentation (Clinical) Abstracts

A study on clinical outcomes of Rathke’s cleft cyst in patients with

or without surgical treatment

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Gigi Y.C. Chong , Kathryn C.B. Tan , Emmy Y.F. Lau , Alta L.Y. Lai , Kenyon K.Y. Man , T.M.
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Chan , Warren K.W. Leung , Jenny Y.Y. Leung 1
1. Department of Medicine and Geriatrics, Ruttonjee Hospital; 2. Department of Medicine, Queen Mary Hospital;
3. Department of Medicine, Pamela Youde Nethersole Eastern Hospital; 4. Department of Radiology, Pamela
Youde Nethersole Eastern Hospital; 5. Department of Radiology, Queen Mary Hospital 6. Department of Radiology,
Ruttonjee Hospital
Introduction / Background / Objectives: 26% had one or more axis hormonal dysfunction. Imaging features
were variable. The pathognomonic feature of intracystic nodule
We have observed that the incidence of Rathke’s cleft cyst (RCC)
increased. While most RCCs are asymptomatic, some cause was present in only 22.9%. For the surgical group, improvement
symptoms or complications. Recurrence was also noted after in visual field defect was noted in 14 patients (84.6%) and
surgery. Objectives: 1) To investigate the clinical presentation, improvement of headache was noted in 15 patients (78.9%) after
hormonal dysfunction, imaging characteristics and clinical course surgery. Sixteen patients (43.2%) developed one or more new
of RCC, either managed conservatively or surgically; and 2) To pituitary dysfunctions after surgery. Recurrence after surgery
identify factors associated with cyst progression and predictors for was noted in 60% of patients over a median follow-up of 6.9
cyst recurrence after surgery. years. Predictors for recurrence included age ≤ 50 years at time
of surgery (odds ratio [OR] 9.54, p = 0.025), residual cyst after
surgery (OR 7.09, p = 0.048) and headache at presentation
Methods: (OR 7.09, p = 0.048). Among the patients who were managed
conservatively, 32.1% developed cyst progression while 67.9%
A retrospective review of 105 patients from 3 hospitals on Hong had a static or decreased cyst size. Median time to progression of
Kong Island (QMH, PYNEH, RH) with the diagnosis of RCC identified cysts was 14 months. Only one patient developed new endocrine
from a word search of radiology reports from January 1999 to dysfunction.
March 2019.

Conclusion:
Results / Outcomes:
RCC is a benign disease, with two-thirds of our patients having
Over a median follow-up of 6 years, 68 patients (65%) were a static or decreased cyst size. RCC rarely gave rise to additional
managed conservatively while 37 patients (35%) underwent endocrine dysfunction. Surgery is a treatment option to alleviate
surgery. The mean age at diagnosis was 49 ± 17 years. Incidental visual field defect and headache, but carries risks of new endocrine
finding and headache were the most common presentations for deficiencies.
conservative and surgical groups, respectively. At presentation,

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