Stereotactic radiosurgery to treat presumed Rathke's cleft cysts

Objective. Stereotactic radiosurgery (SRS) has been developed as a clinical treatment method for certain brain tumours that does not need craniotomy. As a more accurate radiation technique, SRS can deliver a relatively large dose of stereotactic radiation to a conformal target with less normal brain tissue irradiated in a single treatment. The aim of this study is to evaluate the therapeutic effects of SRS for Rathke's cleft cysts (RCCs). Methods. SRS was performed using a rotating gamma ray unit in seven selected patients with symptomatic RCCs diagnosed upon typical MR imaging combined with clinical manifestation. The patients included one male and six females with an age range from 25 to 63 years (mean 43.4 years). Five patients presented with headache, three with menstrual disorder or infertility and one with vision impairment. No other endocrine dysfunction was observed. SRS was performed in the patients with a central dose varied from 22.6 to 40 Gy (mean 32.5 Gy) and a peripheral dose from 9 to 20 Gy (mean 13.4 Gy). Results. The patients were followed up for 11-105 months (mean 38.6 months) after SRS. All symptoms that presented before treatment were relieved within 3-6 months post-SRS and no endocrine dysfunction was developed during the follow-up period. MR imaging demonstrated that the RCCs were completely disappeared in five cases and significantly shrunken in the other two cases. No recurrence was observed in any cases during the follow-up. Conclusion. This study demonstrates that SRS can treat RCCs effectively without evident side effects.