Anterior pituitary function in Rathke’s cleft cysts <i>versus</i> nonfunctioning pituitary adenomas
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- Fujii Mizue
- Department of Diabetology and Endocrinology, Kanazawa Medical University, Uchinada 920-0293, Japan
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- Nakagawa Atsushi
- Department of Diabetology and Endocrinology, Kanazawa Medical University, Uchinada 920-0293, Japan
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- Tachibana Osamu
- Department of Neurosurgery, Kanazawa Medical University, Uchinada 920-0293, Japan
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- Iizuka Hideaki
- Department of Neurosurgery, Kanazawa Medical University, Uchinada 920-0293, Japan
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- Koya Daisuke
- Department of Diabetology and Endocrinology, Kanazawa Medical University, Uchinada 920-0293, Japan
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抄録
<p>Although Rathke’s cleft cysts (RCCs) are common sellar/parasellar lesions, studies examining pituitary function in patients with nonsurgical RCC are limited. This study aimed to clarify the importance of RCCs, including small nonsurgical ones, as a cause of hypopituitarism by determining the prevalence of pituitary hormone secretion impairment and its relationship to cyst/tumor size in patients with RCC and in those with nonfunctioning pituitary adenoma (NFA). We retrospectively investigated the basal levels of each anterior pituitary hormone, its responses in the stimulation test(s), and cyst/tumor size in patients with RCC (n = 67) and NFA (n = 111) who were consecutively admitted to our hospital for endocrinological evaluation. RCCs were much smaller than NFAs (median height, 12 vs. 26 mm). The prevalence of gonadotropin, PRL, and GH secretion impairment in RCC was lower in comparison to NFA (19% vs. 44%, 34% vs. 61%, and 24% vs. 46%, respectively), whereas the prevalence of TSH and ACTH secretion impairment was comparable (21–27% and 17–24%, respectively). A significant positive relationship between cyst/tumor size and number of impaired hormones was observed in both groups, but smaller cysts could cause hormone secretion impairment in RCC. Stimulation tests suggested that most hormone secretion impairment was attributable to the interrupted hypothalamic-pituitary axis in both groups. Therefore, RCC, even small ones, can cause pituitary dysfunction. Different mechanisms may underlie hypothalamic–pituitary interruption in RCC and NFA.</p>
収録刊行物
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- Endocrine Journal
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Endocrine Journal 68 (8), 943-952, 2021
一般社団法人 日本内分泌学会
