REVIEW article
Front. Endocrinol.
Sec. Pituitary Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1630695
This article is part of the Research TopicSurgery and Management of Pituitary Region Tumours and Their Endocrine OutcomesView all 14 articles
The Endocrine Spectrum of Rathke Cleft Cysts
Provisionally accepted
- 1Department of Gynecological Endocrinology, Medical University of Warsaw, 00315, Warsaw, Poland
- 2Department of Neurosurgery, Maria Sklodowska-Curie National Research Institute of Oncology, 02781, Warsaw, Poland
- 3INVICTA Fertility and Reproductive Center, 00019, Warsaw, Poland
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Rathke cleft cysts (RCCs) are rare non-neoplastic lesions of the pituitary gland. Usually, these cysts are small and remain asymptomatic clinically. For unknown reasons, in some cases, RCCs enlarge and cause symptoms such as headaches, visual disturbances, and pituitary gland dysfunctions.The literature lacks comprehensive reviews or guidelines that summarize clinicians' knowledge about hormonal assessment in symptomatic cases. We present a review of the literature focused on symptomatic cases of RCCs, manifesting with hormonal imbalance.Hormonal symptoms occur in 19.4-81% of symptomatic cases. The most common hormonal dysfunction is hyperprolactinemia, found in even 46% of cases, and the second most frequent is hypogonadism. The improvement after surgery is hesitant, between 19% and 67.8%, and is the worst in secondary hypothyroidism. In the pediatric patient group, hormonal dysfunctions are the most common presentation of such a lesion. Dysfunction of the posterior pituitary gland in the course of symptomatic RCCs can result in treatment-resistant diabetes insipidus and syndrome of inappropriate antidiuretic hormone secretion. It should be emphasized that among the endocrine disorders of RCCs in young premenopausal women, menstrual disorders and related fertility problems are prevalent.Irregular menstrual cycles or amenorrhea are reported in up to 17% of symptomatic RCCs.Endocrinologists and neurosurgeons must be acutely aware of hormonal imbalances in RCCs and conduct hormonal evaluations in every case of symptomatic RCC to enhance the management of these lesions. Guidelines for managing symptomatic cases of RCC are necessary to improve patient care and outcomes.
Keywords: symptomatic Rathke cleft cyst, endocrine disorder, Diabetes Insipidus, Menstrual disorders, pituitary tumors
Received: 18 May 2025; Accepted: 29 Aug 2025.
Copyright: © 2025 Rzewuska, Kunicki and Kunicki. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Natalia Rzewuska, Department of Gynecological Endocrinology, Medical University of Warsaw, 00315, Warsaw, Poland
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