scholarly journals A Rare Case of Rathke’s Cleft Cyst Apoplexy

2021 ◽  
Vol 5 (0-2) ◽  
pp. 23
Author(s):  
Amalina Che Din ◽  
Celine Fong ◽  
Chon Sum Ong
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Rare Case ◽  
Pituitary Apoplexy ◽  
Squamous Metaplasia ◽  
Csf Leak ◽  
Focal Lesion ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Stiff Neck ◽  
Rathke's Cleft

The occurrence of symptomatic Rathke's cleft cyst (RCC) apoplexy is extremely rare. This is often misdiagnosed due to similar presentations to subarachnoid haemorrhage and pituitary apoplexy. This case highlights an excellent example of similar clinical presentation and serves as a learning case for clinicians. A 40-year-old lady presented to a district hospital with 9 days of worsening severe headache associated with blurring of vision, photophobia, stiff neck, nausea and vomiting. Nuchal rigidity and Brudzinski’s positive. Blood test showed hyponatremia, raised inflammatory markers and normal dynamic pituitary function test. CT Head demonstrated no evidence of space-occupying lesion or intracranial haemorrhage. Lumbar puncture showed xanthochromia positive consistent with subarachnoid haemorrhage. MRI head advised by Neurosurgery team and revealed a focal lesion involving anterior pituitary macroadenoma with mass effect on optic chiasm with possible haemorrhage within. Further assessment in tertiary hospital confirmed loss of visual acuity and field deficit. Patient underwent emergency endoscopic transnasal transsphenoidal resection of apoplectic tumour and repair of CSF leak with graft from thigh. Histopathology report showed a Rathke’s cleft cyst with squamous metaplasia. Post operatively, the patient developed sinusitis which fully recovered, and MRI showed good decompression. The author demonstrated a rare case of symptomatic RCC which was initially presumed to be pituitary apoplexy. Radiology imaging and treatment approach for both conditions are quite similar and can only be differentiated by histopathology. Further research is required to identify the causes and risk factors of RCC apoplexy to aid early detection and diagnosis.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S23

Rathke's cleft cyst mimiking pituitary apoplexy: a case report

2018 ◽  
Author(s):  
Ines Barka ◽  
Faiza Bensmaine ◽  
Moctar Bah ◽  
Clara Bouche ◽  
Jean Francois Gautier
Keyword(s):  
Case Report ◽  
Pituitary Apoplexy ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft

scholarly journals Craniopharyngioma arising in a Rathke's cleft cyst: case report

2015 ◽  
Vol 15 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Ahmed K. Alomari ◽  
Brian J. Kelley ◽  
Eyiyemisi Damisah ◽  
Asher Marks ◽  
Pei Hui ◽  
...  
Keyword(s):  
Squamous Metaplasia ◽  
Molecular Classification ◽  
Beta Catenin ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Ki 67 ◽  
Patient Will ◽  
Rim Enhancement ◽  
Rathke's Cleft ◽  
Sellar Lesion

Craniopharyngioma is one of the most common non-glial intracranial tumors of childhood. Its relation to Rathke's cleft cyst (RCC) is controversial, and both lesions have been hypothesized to lie on a continuum of cystic ectodermal lesions of the sellar region. The authors report on a 7-year-old boy who presented with decreased visual acuity, presumably of at least 2 years' duration, and was found to have a 5.2-cm sellar lesion with rim enhancement. Histological examination of the resected lesion showed a mixture of areas with simple RCC morphology with focal squamous metaplasia and areas with typical craniopharyngioma morphology. Immunohistochemical staining with CK20 and Ki 67 differentially highlighted the 2 morphological components. Testing for beta-catenin and BRAF mutations was negative in the craniopharyngioma component, precluding definitive molecular classification. Follow-up imaging showed minimal residual enhancement and the patient will be closely followed up with serial MRI. Given the clinical and histological findings in the case, a progressive transformation of the RCC to craniopharyngioma seems to be the most plausible explanation for the co-occurrence of the 2 lesion types in this patient. An extensive review of previously proposed theories of the relationship between craniopharyngioma and RCC is also presented.

Symptomatic Rathke's Cleft Cyst with Pituitary Adenoma: Case Report

Neurosurgery ◽  
1985 ◽  
Vol 17 (4) ◽  
pp. 657-659 ◽  
Author(s):  
Steven E. Swanson ◽  
William F. Chandler ◽  
Joseph Latack ◽  
Katerina Zis
Keyword(s):  
Case Report ◽  
Pituitary Adenoma ◽  
Operative Treatment ◽  
Rare Case ◽  
Diagnostic Evaluation ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Visual Symptoms ◽  
Rathke's Cleft

Abstract A rare case of a pituitary adenoma found in association with a symptomatic Rathke's cleft cyst in a 34-year-old woman presenting with headaches, visual symptoms, and amenorrhea is described. The diagnostic evaluation and operative treatment of these coincident lesions are discussed.

Rathke's cleft cyst presenting as pituitary apoplexy

2002 ◽  
Vol 9 (1) ◽  
pp. 76-79 ◽  
Author(s):  
Sanjay J. Pawar ◽  
Rewati Raman Sharma ◽  
Santosh D. Lad< ◽  
Ebenezer Dev ◽  
Rama Verma Devadas
Keyword(s):  
Pituitary Apoplexy ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft

scholarly journals Rathke's Cleft Cyst or Pituitary Apoplexy: A Case Report and Literature Review

2018 ◽  
Vol 6 (3) ◽  
pp. 544-547 ◽  
Author(s):  
Jeton Shatri ◽  
Ilir Ahmetgjekaj
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Pituitary Apoplexy ◽  
Rathke’S Cleft Cyst ◽  
Resonance Imaging ◽  
High Concentration ◽  
Rathke's Cleft Cyst ◽  
Rathke Cleft Cyst ◽  
Rathke's Cleft

BACKGROUND: During the examination of the sellar region by magnetic resonance imaging, hyperintensity in T1 weighted is a common finding. This signal intensity has different sources, and its significance depends on the clinical context. Pathologic variations in T1 signal hyperintensity may be related to clotting of blood (pituitary apoplexy) or the presence of a high concentration of protein (Rathke cleft cyst). The purpose of this study is to describe the significance of intracystic nodule, a diagnostic characteristic found in Rathke's cleft cyst, on MRI.CASE REPORT: We will present the case of a 20–year-old girl which referral to our hospital for head examination with magnetic resonance imaging because she has a post-traumatic headache. Pathological findings presented in T1-weighted hyperintensity intrasellar which persist even in T1 weighted-Fat suppression. These changes signal the presence of methemoglobin imposes. The patient is a referral to laboratory tests which result in rate except for slight value increase of prolactin. Recommended controller examination after a month but finding the same results which exclude the presence of methemoglobin.CONCLUSION: Morphological characteristics and signal intensity can impose the presence of high concentration of protein (Rathke cleft cyst).

Endoscopic endonasal cyst fenestration into the sphenoid sinus using the mucosa coupling method for symptomatic Rathke’s cleft cyst: a novel method for maintaining cyst drainage to prevent recurrence

2020 ◽  
Vol 133 (6) ◽  
pp. 1710-1720
Author(s):  
Hiroyoshi Kino ◽  
Hiroyoshi Akutsu ◽  
Shuho Tanaka ◽  
Takuma Hara ◽  
Hidetaka Miyamoto ◽  
...  
Keyword(s):  
Sphenoid Sinus ◽  
Coupling Method ◽  
Conventional Group ◽  
Csf Leak ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Repeat Surgery ◽  
Rathke's Cleft ◽  
Cyst Fenestration ◽  
Mc Method

OBJECTIVERathke’s cleft cyst (RCC) is a benign cystic lesion with a relatively high incidence of local recurrence that occasionally requires repeat surgery. To prevent recurrence, simple cyst fenestration and drainage of the cyst contents to the sphenoid sinus is recommended, but it occasionally recurs. The authors postulated that obstruction of fenestration is a main cause of recurrence, and they developed a method, named the “mucosa coupling method (MC method),” that maintains persistent drainage. In this method, the RCC epithelium and the mucosa of the sphenoid sinus are connected, which promotes re-epithelialization between the two epithelia, maintaining persistent drainage. The outcome of this method was compared with that of conventional cyst fenestration.METHODSIn a consecutive series of 40 patients with RCC, the surgical strategy was changed during the study period: from December 2009 to September 2014 (the conventional period), 24 patients were scheduled to be treated using the conventional fenestration method, whereas from September 2014 to September 2017 (the MC period), 16 patients were scheduled to be treated using the MC method. However, because of an intraoperative CSF leak, the fenestration was closed during surgery in 3 patients in the conventional period and 2 in the MC period; therefore, these 5 patients were excluded from the analysis. Twenty-one patients treated with the conventional fenestration method (conventional group) and 14 patients treated with the MC method (MC group) were analyzed. All patients regularly underwent MRI after surgery to detect reaccumulation of cyst contents. The rate of reaccumulation with and without reoperation, visual outcomes, endocrinological outcomes, and postoperative complications were compared between these two groups.RESULTSThe median follow-up period in all 35 patients was 48.0 months (range 1–96 months), 54.0 months (range 1–96 months) in the conventional group and 35.5 months (range 12–51 months) in the MC group. No reaccumulation was detected on MRI in the 14 patients in the MC group, whereas it was noted in 9 (42.9%) of 21 patients in the conventional group, and 2 of these 9 patients required repeat surgery. There were no significant differences in visual and endocrinological outcomes and complications between these two groups.CONCLUSIONSThe MC method for RCC is effective for preventing obstruction of cyst fenestration, which contributes to preventing cyst reaccumulation. Furthermore, this method is equivalent to the conventional fenestration method in terms of visual and endocrinological outcomes and the complication rate.

Symptomatic Rathke's cleft cyst

1977 ◽  
Vol 47 (3) ◽  
pp. 451-458 ◽  
Author(s):  
Jun Yoshida ◽  
Tatsuya Kobayashi ◽  
Naoki Kageyama ◽  
Masaki Kanzaki
Keyword(s):  
Electron Microscopy ◽  
Tissue Culture ◽  
Rare Case ◽  
Light And Electron Microscopy ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Content Type ◽  
Rathke's Cleft ◽  
Fine Print

✓ A rare case is reported in which a symptomatic Rathke's cleft cyst was studied by light and electron microscopy and tissue culture. The findings are compared with those of a craniopharyngioma studied in the same way. The patient was a 26-year-old woman presenting with headache, chiasmatic syndrome, and hypopituitarism. A cyst containing a mural nodule was partially removed and an Ommaya reservoir placed in the operative site for further treatment. The cyst wall was composed of connective tissue and three kinds of epithelial cells: non-ciliated squamous, ciliated columnar, and mucous-secreting cells. The morphology of these cells in vitro was similar to prickle cells seen in craniopharyngioma and the epidermis. It is concluded that both Rathke's left cyst and craniopharyngioma originate in remnants of Rathke's pouch, but at times may show some histological differences.

Rathke's cleft cyst with pituitary apoplexy: case report

1999 ◽  
Vol 41 (11) ◽  
pp. 832-834 ◽  
Author(s):  
H. Nishioka ◽  
H. Ito ◽  
T. Miki ◽  
T. Hashimoto ◽  
H. Nojima ◽  
...  
Keyword(s):  
Case Report ◽  
Pituitary Apoplexy ◽  
Rathke’S Cleft Cyst ◽  
Rathke's Cleft Cyst ◽  
Rathke's Cleft
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