Rathke’s Cleft Cyst Abscess—An Unusual Guest in The Sella

Abscess formation within a Rathkes’s cleft cyst (RCC) is extremely rare, particularly at a young age. We report the case of a young girl with abscess formation in RCC. A 21-year-old female presented with headache, vomiting, visual deterioration and features suggestive of hypopituitarism. She had bit...

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Autores principales:	Piyush Lodha, Srinivas Rao P, Vijay Sheker Reddy Danda, Gollapudi Prakash Rao
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical Publishers, Inc. 2021
Materias:	rathke’s cleft cyst abscess pituitary mass lesion endoscopic transsphenoidal resection Surgery RD1-811 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/5023e09516fd47769b5b6d156836c840
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spelling	oai:doaj.org-article:5023e09516fd47769b5b6d156836c8402021-11-25T01:45:59ZRathke’s Cleft Cyst Abscess—An Unusual Guest in The Sella2277-954X2277-916710.1055/s-0041-1726600https://doaj.org/article/5023e09516fd47769b5b6d156836c8402021-11-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1726600https://doaj.org/toc/2277-954Xhttps://doaj.org/toc/2277-9167Abscess formation within a Rathkes’s cleft cyst (RCC) is extremely rare, particularly at a young age. We report the case of a young girl with abscess formation in RCC. A 21-year-old female presented with headache, vomiting, visual deterioration and features suggestive of hypopituitarism. She had bitemporal hemianopia with impairment of visual acuity. MRI revealed a cystic lesion in the sella with suprasellar extension and peripheral rim enhancement. On the basis of history and imaging, this was indistinguishable from more commonly encountered pituitary pathology. She underwent transsphenoidal decompression, which revealed yellowish purulent material that when cultured grew Staphylococcus epidermidis. Histological examination revealed numerous neutrophils and cyst wall lining with features characteristic of RCC. Postoperatively, she received antibiotics and replacement therapy for hypopituitarism. Three months later, she experienced deterioration in visual fields. Considering persistent disease, she underwent redo surgery which revealed similar findings. Postsurgery, pituitary MRI revealed an empty sella syndrome. Thereafter, follow-up for 1 year was stable with permanent diabetes insipidus and multiple pituitary hormone deficiency on supplementation. Although uncommon, we recommend considering RCC abscess as a differential diagnosis of a pituitary mass lesion, as predicting its presence can be difficult preoperatively. Persistent or recurrent disease is common in these cases, so timely diagnosis and adequate surgical drainage leads to lower morbidity and mortality.Piyush LodhaSrinivas Rao PVijay Sheker Reddy DandaGollapudi Prakash RaoThieme Medical Publishers, Inc.articlerathke’s cleft cyst abscesspituitary mass lesionendoscopic transsphenoidal resectionSurgeryRD1-811Neurology. Diseases of the nervous systemRC346-429ENIndian Journal of Neurosurgery (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	rathke’s cleft cyst abscess pituitary mass lesion endoscopic transsphenoidal resection Surgery RD1-811 Neurology. Diseases of the nervous system RC346-429
spellingShingle	rathke’s cleft cyst abscess pituitary mass lesion endoscopic transsphenoidal resection Surgery RD1-811 Neurology. Diseases of the nervous system RC346-429 Piyush Lodha Srinivas Rao P Vijay Sheker Reddy Danda Gollapudi Prakash Rao Rathke’s Cleft Cyst Abscess—An Unusual Guest in The Sella
description	Abscess formation within a Rathkes’s cleft cyst (RCC) is extremely rare, particularly at a young age. We report the case of a young girl with abscess formation in RCC. A 21-year-old female presented with headache, vomiting, visual deterioration and features suggestive of hypopituitarism. She had bitemporal hemianopia with impairment of visual acuity. MRI revealed a cystic lesion in the sella with suprasellar extension and peripheral rim enhancement. On the basis of history and imaging, this was indistinguishable from more commonly encountered pituitary pathology. She underwent transsphenoidal decompression, which revealed yellowish purulent material that when cultured grew Staphylococcus epidermidis. Histological examination revealed numerous neutrophils and cyst wall lining with features characteristic of RCC. Postoperatively, she received antibiotics and replacement therapy for hypopituitarism. Three months later, she experienced deterioration in visual fields. Considering persistent disease, she underwent redo surgery which revealed similar findings. Postsurgery, pituitary MRI revealed an empty sella syndrome. Thereafter, follow-up for 1 year was stable with permanent diabetes insipidus and multiple pituitary hormone deficiency on supplementation. Although uncommon, we recommend considering RCC abscess as a differential diagnosis of a pituitary mass lesion, as predicting its presence can be difficult preoperatively. Persistent or recurrent disease is common in these cases, so timely diagnosis and adequate surgical drainage leads to lower morbidity and mortality.
format	article
author	Piyush Lodha Srinivas Rao P Vijay Sheker Reddy Danda Gollapudi Prakash Rao
author_facet	Piyush Lodha Srinivas Rao P Vijay Sheker Reddy Danda Gollapudi Prakash Rao
author_sort	Piyush Lodha
title	Rathke’s Cleft Cyst Abscess—An Unusual Guest in The Sella
title_short	Rathke’s Cleft Cyst Abscess—An Unusual Guest in The Sella
title_full	Rathke’s Cleft Cyst Abscess—An Unusual Guest in The Sella
title_fullStr	Rathke’s Cleft Cyst Abscess—An Unusual Guest in The Sella
title_full_unstemmed	Rathke’s Cleft Cyst Abscess—An Unusual Guest in The Sella
title_sort	rathke’s cleft cyst abscess—an unusual guest in the sella
publisher	Thieme Medical Publishers, Inc.
publishDate	2021
url	https://doaj.org/article/5023e09516fd47769b5b6d156836c840
work_keys_str_mv	AT piyushlodha rathkescleftcystabscessanunusualguestinthesella AT srinivasraop rathkescleftcystabscessanunusualguestinthesella AT vijayshekerreddydanda rathkescleftcystabscessanunusualguestinthesella AT gollapudiprakashrao rathkescleftcystabscessanunusualguestinthesella
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Rathke’s Cleft Cyst Abscess—An Unusual Guest in The Sella

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