Abscess formation in Rathke's cleft cyst

Abstract

Two patients are discussed who presented at our Institute with endocrine dysfunction and sellar enlargement. CT scans revealed intra and suprasellar expanding lesions with ring enhancement. The postoperative histological examination showed remnants of Rathke's cleft cyst together with signs of inflammation. CT and MRI pictures, and possible mechanisms of abscess formation in this region are discussed.

Blurred Vision Caused by Inflammation of the Optic Nerves Due to a Pituitary Abscess-Case Report-

“…The optic nerve is compressed by the abscess, and visual disorder occurs. 3,5,10,16) In our patient, blurred vision appeared without compression of the optic nerves. However, the optic nerves harbored high-intensity lesions on MR imaging.…”

“…1,10,16,17) Therefore, the differential diagnosis of Rathke's cleft cyst, cystic pituitary adenoma, craniopharyngioma, and pituitary abscess is difficult if a ring-enhanced lesion is present in the pituitary region. [4][5][6][7]18) Pituitary abscess tends to occur after surgery for a tumor in the pituitary region, 17) and sometimes occurs in pituitary adenoma, 12,17) Rathke's cleft cyst, 3,10,13) and craniopharyngioma. 14) The lesion may be localized in the pituitary regions because degradation of immunocompetence, presence of necrotic tissue, 2) and complicating hypopituitarism contribute to reduced resistance to infection.…”

“…Symptoms and signs of pituitary abscess include headache, 9,10,13,[16][17][18] visual disorder due to compression of the pituitary abscess, 3,5,10,16) anterior pituitary dysfunction, 13) fever, and meningitis. 8,10,17) However, the only symptom may be diabetes insipidus.…”

“…Pituitary abscess usually manifests as headache, 9,10,13,[16][17][18] blurred vision and visual field defect due to compression of the optic nerves, 3,5,10,16) symptoms of hormone degradation of the adenohypophysis, 13) fever, or meningitis. 8,10,17) Neuroimaging of a pituitary abscess usually demonstrates abnormalities localized in the hypophysis, 17) and rare in the hypothalamus 1) or frontal lobe.…”

Pituitary Abscess Manifesting as Meningitis and Photophobia Associated With Rathke's Cleft Cyst in a Child -Case Report-

“…2,3,[7][8][9][12][13][14]16,17,19,[21][22][23][24]26) Twelve patients were female, seven were male, and the mean age of these patients was 44.1 years (range 12-69 years). Three were pediatric cases.…”