Infected Rathke cleft cysts: distinguishing factors and factors predicting recurrence

Neurosurgery
Matthew C TateManish K Aghi

Abstract

Rathke cleft cysts (RCCs) are benign sellar lesions that are generally asymptomatic but sometimes warrant transsphenoidal drainage. Small case reports have described infected RCCs, but this phenomenon remains uncharacterized. We reviewed RCCs over 23 years at our institution to determine factors predicting infection and recurrence. We retrospectively reviewed the magnetic resonance images, laboratory results, microbiology, and pathology of 176 RCC patients (1985-2008) who underwent initial operation at our institution (n = 170) or at another institution followed by recurrence managed at our institution (n = 6). There were 3 RCC categories: cysts cultured intraoperatively during initial surgery (n = 21), cysts not cultured during initial surgery but cultured during subsequent surgery (n = 9), and cysts that were never cultured (n = 146). Cultured cysts were larger (1.6 vs 1.2 cm; P = .002) and had more frequent pituitary dysfunction (76% vs 30%; P < .001) than noncultured cysts. Restricted diffusion was also more common in cultured cysts (50% vs 0%; P = .02). Of cysts cultured at initial or subsequent surgery, 48% and 44%, respectively, had positive cultures (n = 14) and were treated with antibiotics. The most common organisms w...Continue Reading

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Citations

Oct 23, 2013·Journal of Neuro-oncology·Seunggu J HanManish K Aghi
May 3, 2014·Surgical Infections·Okacha NaamaBrahim Elmoustarchid
May 20, 2014·Journal of Neurosurgery·Arman JahangiriManish K Aghi
Sep 29, 2011·Clinical Endocrinology·Raluca TrifanescuNiki Karavitaki
Mar 6, 2016·World Neurosurgery·Michael M SafaeePhilip V Theodosopoulos
Feb 17, 2015·BioMed Research International·Yukai SuAkio Morita
Jun 16, 2011·Neurosurgery·Matthew B PottsManish K Aghi
Jan 17, 2020·Neurosurgery·Pankaj K AgarwallaBrooke Swearingen
Nov 8, 2014·Journal of Surgical Case Reports·Ian C CoulterPhilip J Kane

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