Natural history of rathke

Menendez Torre Edelmiro Luis; Hurtado Alba Gutierrez; Ana Irigaray; Rojas Patricia Martin; Molero Inmaculada Gonzalez; Almudena Vicente; Marta Araujo; Cindy Idobro; Taibo Rocio Villar; Betina Biagetti; Alfonso Soto-Moreno; Salat Manel Mateu; Fernando Guerrero; Moure Rodriguez Maria Dolores; Fano Miguel Paja; Fernando Cordido; Pedro Iglesias; Ollero M Dolores; Maso Ana Aulinas

doi:10.1530/endoabs.99.P319

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Endocrine Abstracts (2024) 99 P319 | DOI: 10.1530/endoabs.99.P319

ECE2024 Poster Presentations Pituitary and Neuroendocrinology (120 abstracts)

Natural history of rathke’s cleft cysts. a retrospective analysis of a fifteen centers experience in spain

Edelmiro Luis Menendez Torre ^1,2,3 , Alba Gutierrez Hurtado ¹ , Ana Irigaray ⁴ , Patricia Martin Rojas ⁵ , Inmaculada González Molero ⁶ , Almudena Vicente ⁷ , Marta Araujo ⁸ , Cindy Idobro ⁸ , Rocio Villar Taibo ⁹ , Betina Biagetti ¹⁰ , Alfonso Soto-Moreno ¹¹ , Manel Mateu Salat ¹² , Fernando Guerrero ¹³ , Maria Dolores Moure Rodriguez ¹⁴ , Miguel Paja Fano ¹⁵ , Fernando Cordido ¹⁶ , Pedro Iglesias ¹⁷ , M Dolores Ollero ¹⁸ & Ana Aulinas Maso ¹⁹

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¹Central University Hospital of Asturias, Endocrinology and Nutrition, Oviedo, Spain; ²Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; ³University of Oviedo, Oviedo, Spain; ⁴Navarra Hospital Complex - Navarra Hospital, Pamplona, Spain; ⁵La Paz University Hospital, Madrid, Spain; ⁶Hospital Regional Universitario de Málaga, Málaga, Spain; ⁷Hospital General Universitario de Toledo, Toledo, Spain; ⁸Ramón y Cajal Hospital, Madrid, Spain; ⁹Santiago Clinic Hospital CHUS, Santiago de Compostela, Spain; ¹⁰Vall d’Hebron University Hospital, Barcelona, Spain; ¹¹Virgen del Rocío University Hospital, Sevilla, Spain; ¹²Institut de Recerca Sant Pau, Barcelona, Spain; ¹³Bellvitge University Hospital, L’Hospitalet de Llobregat, Spain; ¹⁴University Hospital of the Crosses, Barakaldo, Spain; ¹⁵Basurto University Hospital, Bilbo, Spain; ¹⁶University Hospital of A Coruña, A Coruña, Spain; ¹⁷Hospital Universitario Puerta de Hierro, Majadahonda, Spain; ¹⁸Navarra Hospital Complex - Navarra Hospital, Endocrinology and Nutrition, Pamplona, Spain; ¹⁹Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

Objective: To evaluate the natural history of Rathke’s cleft cysts (RCC).

Materials and Methods: A multicenter retrospective clinical practice study of adult patients with radiologically diagnosed RCCs since 2000 in 15 tertiary hospitals (SPAIN-QBR study) with a diameter greater than 5 mm, in whom non-surgical follow-up was decided.

Results: A total of 177 patients were followed for 65.8 ± 42.3 months. The mean age was 42.8± 18.1 years, significantly (P<0,01) lower than that of other patients who underwent surgery (48.0 ± 16.4 years). The larger diameter was between 6 and 10 mm in 84 patients (49.7%), 11-20 mm in 86 patients (48.5%), and >20 mm in 11 patients (6.2%). Suprasellar extension was present in 44 (24.9%) and cavernous sinus extension in 3 (1.7%). The largest MRI tumor diameter remained stable or decreased in 133 patients (75.1%) and increased in 44 patients (24.9%). None of the baseline tumor or patient characteristics predicted the evolution of tumor size. During follow-up, 7 patients (3.9%) underwent surgery, in one case by patient decision without previous change, in three 3 cases after clinical events (two cases due to visual changes and one due to hormonal changes) and in another three patients because of significant growth observed on MRI with risk of chiasmatic involvement. Surgery was performed at 27, 43, 55, 80, 84, and 105 months after diagnosis. (Table 1) When baseline clinical covariates were included in a regression model, the only predictor of the need for surgery was the degree of hormonal involvement at baseline.

Conclusion: After a mean of 5 years of follow-up, 24% of patients experienced some increase in RCC size, but without clinical significance. Only 3% needed surgery, which was more likely in those with more hormonal involvement at diagnosis.