Lymphocytic Hypophysitis Secondary to Ruptured Rathke's Cleft Cyst: Case Report and Literature Review.

Lymphocytic Hypophysitis Secondary to Ruptured Rathke's Cleft Cyst: Case Report and Literature Review.

World Neurosurg. 2018 Mar 20;:

Authors: Yang C, Wu H, Bao X, Wang R

Abstract
BACKGROUND: Lymphocytic hypophysitis (LH) is a rare inflammatory lesion in sellar region. LH secondary to ruptured Rathke's cleft cyst (RCC) is even more rarely observed according to published case reports. The clinical characteristics, treatment strategies and prognosis of such lesions remain elusive.
CASE DESCRIPTION: A 58-year-old Chinese woman was admitted to our hospital complaining of initial intermittent headache for 3 years and new development of polydipsia, polyuria, and binocular visual acuity decline for recent 4 months. On admission, endocrine results were normal. Ophthalmic testing showed bitemporal visual field deficits and decreased visual acuity of both eyes. Pituitary dynamic magnetic resonance imaging showed a cystic sellar lesion measuring 5.6mm × 5.2mm × 6.2mm with tumor shrinkage compared with initial neuroimaging. A transsphenoidal surgery was performed for tumor resection. An additional biopsy of the anterior pituitary lobe was conducted because of intraoperative abnormal appearances of the pituitary gland. Pathology examinations revealed the specimen of the cystic lesion to be RCC and exhibited infiltration of massive lymphocytes, diffused plasmocytes, and eosinophils that were diagnostic of LH in the anterior pituitary lobe. During the follow-up, the lesion of LH showed spontaneous shrinkage in absence of steroid treatment after RCC resection. Therefore, we made a final diagnosis of LH secondary to ruptured RCC.
CONCLUSION: We present a rare case of LH secondary to ruptured RCC in a Chinese woman and provide clinical data of such lesions by reviewing literature. Full understanding of the clinical features plays an important role in diagnosis and treatment of LH secondary to ruptured RCC.

PMID: 29572168 [PubMed - as supplied by publisher]

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