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
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.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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