Cystic Lesions of the Pituitary: Clinicopathological Features Distinguishing Craniopharyngioma, Rathke’s Cleft Cyst, and Arachnoid Cyst
Bibliographic record
Abstract
The challenge of distinguishing preoperatively among craniopharyngioma (CR), Rathke’s cleft cyst (RCC), and intrasellar arachnoid cyst (AC) remains a difficult one, but an accurate distinction will aid treatment selection and help to predict the outcome. This study, the largest combined series reported to date, included 21 adults with CR, 26 with RCC, and 5 with AC. The average follow-up period was just under 6 years. Patients with AC were significantly older when they first underwent operation than those in the other groups. Females predominated in the RCC group. Patients with AC had been symptomatic for a shorter time, but the differences were not significant. Pituitary hormone insufficiency and neurological and/or ophthalmological deficits were frequent when patients with CR or RCC were first seen. Endocrine dysfunction was documented in 95 percent of patients with CR but in only 40 percent of those with AC. In patients with CR, the most common features were amenorrhea, impotence or reduced libido, and hyperprolactinemia. Diminished libido was present in two-thirds of RCC patients. Although 80 percent of CRs were >20 mm in diameter radiographically, this was the case for only 18 percent of RCCs. Two-thirds of CR lesions were suprasellar, but all RCC and AC lesions were intrasellar. At least 60 percent of patients in all groups had neurological dysfunction preoperatively. One patient with CR died postoperatively of massive bleeding. Patients with CR had the least favorable prognosis. Significantly more of them required replacement hormones postoperatively. Amenorrhea and galactorrhea were most resistant to surgical treatment. Recurrence rates were 62 percent for CR, 19 percent for RCC, and 20 percent for AC. Cumulative rates of recurrence-free survival for patients with CR were 57 percent at 5 years, 48 percent at 10 years, and 43 percent at 20 years. The figures were 85, 81, and 81 percent, respectively, for RCC and 100, 80, and 80 percent, respectively, for AC. J Clin Endocrinol Metab 1999;84:3972–3982
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".