We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Gamma Knife radiosurgery for Rathke’s cleft cysts: A multicenter survey.
- Authors
Lavezzo, Riccardo; Longhi, Michele; Barresi, Valeria; Zivelonghi, Emanuele; Ricciardi, Giuseppe Kenneth; D’Amico, Anna; Bulgarelli, Giorgia; Polloniato, Paolo Maria; Pinna, Giampietro; Sala, Francesco; Manzoni, Andrea; Leocata, Filippo; Picano, Marco; Arienti, Virginia Maria; Mainardi, Hae Song; Cenzato, Marco; Stefini, Roberto; Camera, Alessandro La; Barzaghi, Lina Raffaella; Losa, Marco
- Abstract
Background: Rathke’s cleft cysts (RCCs) are benign cystic sellar lesions, often incidentally diagnosed but sometimes presenting with visual and/or endocrine disorders. These lesions arise from remnants of the embryologic Rathke’s pouch. They may account for 6-10% of symptomatic sellar and suprasellar lesions and growth rates ranges from 5% to 30% in the different series. Normally asymptomatic cysts are followed by serial imaging, otherwise symptomatic RCCs are managed by surgical decompression. Recurrence of RCCs after surgery, has been described up to 30%, leading occasionally to multiple surgical procedures that increase morbidity. Objective: To evaluate a multicenter experience in the treatment of RCCs with Gamma Knife radiosurgery (GKRS). Methods: We retrospectively analyzed 6 patients (2 male and 4 female) that underwent GKRS for RCCs in three centers (Ospedale Civile Maggiore – Verona, Ospedale Niguarda and Ospedale San Raffaele – Milano) between 2007 and 2017. Presenting symptoms included headache, memory loss, lipothymia, visual field deficit, endocrine disorders till panhypopituitarism. Five patients underwent previous surgery while one patient had a neuroradiological diagnosis of RCC. The radiosurgical technique has already been described in previous reports. After GKRS, follow-up protocol (with some differences among the centers) included MRIs between 3 and 6 months, then annually, visual field testing, and endocrine evaluations. Results: All surgically treated patients (five), were closely followed by clinical and radiological examinations; one patient required a redrainage for cyst’s recurrence after three years. The rationale of treating RCCs with GKRS is based on the observation that these can be considered benign neoplastic lesions with a close relationship with craniopharyngioma, since they share a common histological origin from remnants of the squamous epithelium from Rathke’s cleft. The mean age at time of GKRS was 61 years old; mean prescription dose was 11.4 Gy (range 6,5 – 15 Gy) normalized to the 50% isodose line, and mean follow-up period was 90 months (range 36 – 156 months). No patient required further surgery or developed new visual/endocrine deficit after GKRS. In 5 patients we observed a > 50% volume reduction of the cyst, while in one patient the lesion was stabilized. There are only few previous reports regarding usage of radiation therapy for RCCs, and our series confirm the safety and efficacy of stereotactic radiosurgery. Conclusions: The clinical and radiological findings of our series, with a long follow-up period, suggest that GKRS could be considered a feasible and safe adjuvant treatment for recurrent RCCs.
- Publication
Journal of Radiosurgery & SBRT, 2022, Vol 8, p108
- ISSN
2156-4639
- Publication type
Academic Journal