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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:2144-2147, September 2005
© 2005 American Society of Neuroradiology

PEDIATRICS

Pituitary Cysts in Childhood Evaluated by MR Imaging

Jun-ichi Takanashi^a,c, Hiroko Tada^a, A. James Barkovich^d, Naokatsu Saeki^b and Yoichi Kohno^a

^a Department of Pediatrics , Graduate School of Medicine, Chiba University, Chiba, Japan
^b Department of Neurological Surgery , Graduate School of Medicine, Chiba University, Chiba, Japan
^c Department of Pediatrics , Kameda Medical Center, Kamogawa, Japan
^d Neuroradiology Section, Department of Radiology , University of California, San Francisco, San Francisco, CA

Address correspondence to Jun-ichi Takanashi, Department of Pediatrics, Kameda Medical Center, 929 Higashi-cho, Kamogawa-shi, Chiba 296-8602, Japan

BACKGROUND AND PURPOSE: Pituitary cysts are common findings on pathologic examination and imaging studies. They are generally considered to be rarer in children than in adults; however, no good data exist to substantiate this opinion. We reviewed MR imaging studies to evaluate the frequency and imaging features of pituitary cysts in children.

METHODS: We retrospectively reviewed T1-weighted sagittal images in 341 patients <15 years of age to evaluate for pituitary cysts. Paramagnetic contrast was administered in 86 of the 341 patients. Sagittal or coronal fast spin-echo T2-weighted images were performed in 166 patients. For patients having pituitary cysts, pituitary function was examined by assessing blood levels of pituitary hormones.

RESULTS: A cystic pituitary lesion was recognized in 4 patients (1.2%) aged 1–4 years. None of the 4 manifested endocrinologic signs or symptoms or were the results of their laboratory studies abnormal. All the lesions were sharply demarcated and situated just posterior to the anterior pituitary lobe. All were iso- or hypointense compared with the pons on T1-weighted images without contrast enhancement, suggesting a Rathke cleft cyst. MR imaging of a patient with probable low-grade gliomas in the left hypothalamic region and optic chiasma showed complete resolution of a pituitary cyst at a 1-year follow-up study.

CONCLUSION: The frequency of pituitary cysts on MR imaging in childhood is almost equal to that of Rathke cleft cysts, as assessed in autopsy studies of subjects aged 10 to 29 years. These cysts are common in children and should be considered, in the absence of signs or symptoms of pituitary dysfunction, as incidental findings.

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