A Rare Case of Rathke’s Cleft Cyst Apoplexy

Amalina Che Din ◽  
Celine Fong ◽  
Chon Sum Ong

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

2018 ◽  
Ines Barka ◽  
Faiza Bensmaine ◽  
Moctar Bah ◽  
Clara Bouche ◽  
Jean Francois Gautier

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Namie Kobayashi ◽  
Toshiyuki Oshitari ◽  
Kentaro Kobayashi ◽  
Takatsugu Onoda ◽  
Hidetoshi Ikeda ◽  

We report a case of right optic neuritis caused by Rathke's cleft cyst (RCC) in a young adult. A 15-year-old boy presented with reduced visual acuity in the right eye. He was diagnosed with optic neuritis in the right eye 4 years earlier at other clinics before he was referred to our department. During our one-year examinations, the cause of the reduced vision in his right eye could not be determined conclusively. At the age of 17 years, a RCC was detected by a neurosurgeon who specialized in hypophyseal diseases. He underwent microscopic transsphenoidal resection of the cyst, and his vision recovered to 1.2 and he has had no recurrence for at least 9 months. We suggest that repeated rupturing of the RCC was the cause of the optic neuritis, and a RCC can be successfully treated by surgery even after 3 years of optic neuritis.

2002 ◽  
Vol 9 (1) ◽  
pp. 76-79 ◽  
Sanjay J. Pawar ◽  
Rewati Raman Sharma ◽  
Santosh D. Lad< ◽  
Ebenezer Dev ◽  
Rama Verma Devadas

Neurosurgery ◽  
1985 ◽  
Vol 17 (4) ◽  
pp. 657-659 ◽  
Steven E. Swanson ◽  
William F. Chandler ◽  
Joseph Latack ◽  
Katerina Zis

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.

2018 ◽  
Vol 6 (3) ◽  
pp. 544-547 ◽  
Jeton Shatri ◽  
Ilir Ahmetgjekaj

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).

2011 ◽  
Vol 65 (5) ◽  
pp. 451
Ka Yeon Choo ◽  
Hyun Seok Choi ◽  
So Lyung Jung ◽  
Bum soo Kim ◽  
Sin Soo Jeun ◽  

1999 ◽  
Vol 41 (11) ◽  
pp. 832-834 ◽  
H. Nishioka ◽  
H. Ito ◽  
T. Miki ◽  
T. Hashimoto ◽  
H. Nojima ◽  

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