Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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May 15, 2014
Rathke Cleft Cyst
- Rathke cleft cyst arises from the embryologic remnant of Rathke pouch.
- Clinical Presentation: Sellar or suprasellar lesions mostly asymtomatic but can present with visual disturbance, hormonal imbalance, or headache if large in size
- Intracystic nodule is pathognomonic and can be demonstrated in 17–77% of cases. The nodule can be mobile in the cyst.
- Key Diagnostic Features: CT: The cyst is typically hypodense with hyperdense intracystic nodule. MRI: T1WI - hypo- or hyperintense cyst content with hyperintense nodule. T2WI - mostly hyperintense cyst content with hypointense nodule.
- Pathology: Nodule consists of cholesterol, protein, and cellular debris
- DDx: Carniopharyngioma, cystic pituitary adenoma, and teratoma
- Rx: Observation, cyst aspiration, and resection
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