A Cyst of Rathke's Cleft

Fairburn, B.; Larkin, I. M.

doi:10.3171/jns.1964.21.3.0223

Cited by 39 publications

(5 citation statements)

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“…Rathke's cleft cyst is midline, often placed in the anterior-superior portion of the sella between the anterior and the posterior lobe of the pituitary gland 12 . It is generally believed this location is typical and strongly suggests the diagnosis of Rathke's cleft cyst 12 .…”

Section: Discussionmentioning

confidence: 99%

Imaging of Rathke's Cleft Cysts: Criteria for a Differential Diagnosis

Riva

Meli

Chiaramonte³

et al. 2007

Neuroradiol J

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Rathke's cleft cysts are a congenital disorder of the pituitary gland and derive from abnormalities of the development of the adenohypophisis. The variability of the MRI signal of Rathke's cleft cyst hampers the differential diagnosis with the other cystic lesions of the pituitary gland. Nevertheless a comparison between the various findings reported from by author we reviewed indicates that a description of useful criteria for a differential diagnosis is possible. We suggest that the mean age at onset, the symptoms, the magnetic signal intensity, the location within the gland, the relations with the surrounding structures and the behaviour after contrast injection should always be considered in the diagnostic work-up of Rathke 's cleft cysts. There is no consensus in the literature on the correct therapeutic protocol. We suggest following up a small asymptomatic Rathke's cleft cyst (except mucoid cysts) because they do not generally enlarge. Surgery is instead the gold standard for symptomatic Rathke's cleft cysts, large Rathke's cleft cysts and mucoid Rathke's cleft cysts. Mucoid Rathke's cleft cysts, even when small, may cause an intense pituitary inflammation which could lead to irreversible endocrine dysfunction.

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Section: Discussionmentioning

confidence: 99%

Imaging of Rathke's Cleft Cysts: Criteria for a Differential Diagnosis

Riva

Meli

Chiaramonte³

et al. 2007

Neuroradiol J

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“…A recidiva dos cistos da fenda de Rathke é rara (5) . Somente alguns autores, mostraram casos de recidiva bem documentados (16)(17) . Segundo alguns autores (5) , o risco de recorrência aumenta nos casos com parte sólida, que contenha epitélio escamoso estratificado, dentro do cisto.…”

Section: Discussionunclassified

Alterações visuais decorrentes do cisto da fenda de Rathke: relato de caso

Rech¹,

Prochnau²,

Rosa³

et al. 2004

Arq. Bras. Oftalmol.

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Os cistos da fenda de Rathke são lesões para-selares, geralmente assintomáticas, presentes em 12 a 33% das autópsias de pacientes com hipófise normal. Ocasionalmente, os cistos podem aumentar de volume a ponto de comprimir estruturas supra-selares e intra-selares, levando ao aparecimento dos sintomas. Clinicamente, os pacientes referem escurecimento visual, além de apresentarem defeitos campimétricos. M.A.S.R., 47 anos, sexo feminino, branca, natural de Pelotas/RS com queixa de embaçamento progressivo da visão do olho direito há 2 meses. Ao exame, constatou-se baixa visual e hemianopsia bitemporal. A tomografia computadorizada evidenciou imagem hipodensa arredondada, de bordos nítidos, em topografia selar, determinando remodelação e alargamento da sela túrcica. A ressonância magnética mostrou lesão expansiva cística localizada na sela túrcica com crescimento supra-selar. A referida lesão apresenta obliteração da cisterna supra-selar e importante compressão sobre o quiasma óptico. A abordagem cirúrgica confirmou a presença de lesão expansiva cística comprimindo o quiasma óptico e o exame de anatomia patológica do material diagnosticou cisto da fenda de Rathke. O exame oftalmológico, três meses após a cirurgia, mostrou melhora da acuidade visual e recuperação total dos defeitos do campo visual. O cisto da fenda de Rathke deve ser incluído no diagnóstico diferencial dos tumores para-selares passíveis de causar compressão da via óptica nervosa e ressalta-se a importância do diagnóstico e tratamento precoce no intuito de prevenir danos estruturais com perdas irreversíveis da função visual, bem como os distúrbios endócrinos.

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“…Rathke's cleft cyst is typically lined by ciliated cuboidal or columnar epithelium and, therefore, is quite distinct from craniopharyngioma which consists of squamous epithelium [3][4][5][6]17]. However, cysts with mixed histological features of Rathke's cleft cysts and craniopharyngioma have been described [5,9,12,18].…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Rathke's Cleft Cyst

et al. 1992

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A rare case of symptomatic Rathke's cleft cyst in a 26-year-old female is reported. The clinical and radiological features of this lesion are described with emphasis on the differential diagnosis between Rathke's cleft cyst and craniopharyngioma.Rathke's cleft cysts present a common incidental intrasellar autopsy finding occurring in 13% to 22% of randomly examined pituitary glands [1]. These lesions rarely, however, enlarge sufficiently enough to cause compression of adjacent neural structures. Although to date, approximately 155 cases of symptomatic Rathke's cleft cysts have been reported in the pertinent literature [2]; the condition continues to be largely unknown to clinicians.The purpose of this case report is to draw attention to this pathological entity which should be considered in the differential diagnosis of cystic lesions in the sellar area. To the best of our knowledge, this is the first case of symptomatic Rathke's cleft cyst to be reported from Saudi Arabia. Case ReportThis 26-year-old Filipino female dietitian presented to the Neurosurgical Division of the King Khalid University Hospital with a two month history of constant headaches which were associated with nausea and nonprojectile vomiting. There were no visual disturbances and apart from oligomenorrhea since puberty, her past medical history was unremarkable. ExaminationThe patient was short in stature (height 140 cm and weighed 37.5 kg). Skin and hair distribution were normal. Neurological status of the patient was normal except for a bi-temporal hemianopia.The plain x-ray of the skull revealed erosion of the dorsum sellae with no sellar abnormality. Cranial computerized tomographic (CT) scan showed a large low density lesion measuring 30×39 mm with faint ring enhancement filling the entire suprasellar space with compression of the third ventricle (Figure 1). The magnetic resonance imaging (MRI) demonstrated the lesion extending into the sella and elevating the floor of the third ventricle. The lesion was hyperintense on both T1 and T2 weighted images except for a small nidus which could have represented a solid component of the lesion. The vertebral angiography disclosed marked dorsal displacement of the distal end of the basilar artery.The basal secretion of the following hormones was normal: T3, T4, TSH, Cortisol, prolactin, LH, FSH, and growth hormone. The pituitary dynamic tests after injection of insulin, TRH, and GnRH revealed inadequate GH and FSH responses. OperationThe patient underwent a right frontotemporal craniotomy. A thin-walled, brown-greenish cyst was encountered. The right optic nerve was stretched over the cyst wall and the right carotid artery was displaced laterally. The cyst was punctured and 35 cc of milky greenish fluid was aspirated. The inferior part of the cyst wall was excised leaving the superior part, which was firmly attached to the floor of the third ventricle, unremoved. Postoperative CourseThe patient recovered well but developed transient diabetes insipidus which was controlled with vasopressin. Two year...

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A Cyst of Rathke's Cleft

Cited by 39 publications

References 5 publications

Imaging of Rathke's Cleft Cysts: Criteria for a Differential Diagnosis

Imaging of Rathke's Cleft Cysts: Criteria for a Differential Diagnosis

Alterações visuais decorrentes do cisto da fenda de Rathke: relato de caso

Symptomatic Rathke's Cleft Cyst

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