October - December 2010, Volume 6, Issue 4

Berker M, Hazer DB, Soylemezoglu F

A case of gonadotropinoma with polycysts as remnants of Rathke's cleft

Acta Endo (Buc) 2010, 6 (4): 513-520
doi: 10.4183/aeb.2010.513

Context. This is a case of gonadotropinoma presented with Rathke's cleft cyst.\r\nObjective. We are presenting a case of gonadotropinoma along with Rathke's cleft cyst which is unique case as being male and symptomatic gonadotropin releasing adenoma.\r\nMethod. A 51 year old man was referred to our institution for evaluation of impotence and loss of libido. His endocrine screening evaluations revealed hypopituitarism with low levels of blood cortisol and ACTH, and high levels of prolactin.\r\nResults. An endonasal transsphenoidal endoscopic approach was performed and upon inspection via endoscope the floor of sella was eroded and following dural incision soft dark\r\ncolored tumor overflowed through sella. Pathology revealed gonadotropinoma with unexpected remnants of Rathke's cleft cyst.\r\nConclusion. Pituitary adenomas and Rathke's cleft cysts have a common embryologic ancestry. Our case was a symptomatic gonadotropinoma consisting of multicystic\r\ncomponent which was then demonstrated as Rathke's cleft cyst in pathological work up.\r\nThis combination may be the result of a coincidence or Rathke's cleft cysts may be the\r\norigin of the pituitary adenomas.

Keywords: Rathke's cleft cyst, gonadotropinoma, sphenoid sinus, contrast\r\nenhancement

Correspondence: Hazer Derya Burcu MD, ?ankiri State Hospital - Neurosurgery ?ankiri State Hospital, Department of Neurosurgery Akso Mah. 18100, ?ankiri 18100.Turkey Tel: 90.376.2129299 Fax: 90.376.3189892 Email: burcuhazer@hotmail.com