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.

尽管 Rathke 裂囊肿 (RCC) 是常见的鞍区/鞍旁病变，但对非手术 RCC 患者垂体功能的研究有限。本研究旨在通过确定 RCC 和非功能性垂体腺瘤 (NFA) 患者垂体激素分泌障碍的患病率及其与囊肿/肿瘤大小的关系，阐明 RCC（包括小型非手术性肾细胞癌）作为垂体功能减退症原因的重要性）。我们回顾性调查了连续入住我院的 RCC ( n = 67) 和 NFA ( n = 111)患者的每种垂体前叶激素的基础水平、其在刺激试验中的反应以及囊肿/肿瘤大小用于内分泌评估。RCC 比 NFA 小得多（中位高度，12与26 毫米）。与 NFA 相比，RCC 中促性腺激素、PRL 和 GH 分泌障碍的发生率较低（19%对44%、34%对61%、24%对分别为 46%），而 TSH 和 ACTH 分泌障碍的患病率相当（分别为 21-27% 和 17-24%）。在两组中观察到囊肿/肿瘤大小与受损激素数量之间存在显着的正相关关系，但较小的囊肿可能导致 RCC 激素分泌受损。刺激试验表明，大多数激素分泌障碍可归因于两组的下丘脑-垂体轴中断。因此，RCC，即使是很小的，也会导致垂体功能障碍。不同的机制可能是 RCC 和 NFA 下丘脑-垂体中断的基础。