Symptomatic Rathke's cleft cyst with amyloid stroma

Area of Science:

• Neuroendocrinology
• Surgical Pathology

Background:

• Rathke's cleft cysts are common incidental findings in pituitaries.
• Symptomatic presentation is rare, but modern diagnostics detect subtle endocrine issues.
• This case highlights a rare symptomatic Rathke's cleft cyst.

Observation:

• The patient presented with panhypopituitarism and visual field defects.
• An unusual feature was the presence of apudamyloid stroma within the cyst.
• This stromal component is previously unreported in Rathke's cleft cysts.

Findings:

• The apudamyloid stroma suggests a role for neural crest-derived cells in cystogenesis.
• The cyst caused significant endocrine dysfunction and mass effect.

Implications:

• Understanding cyst composition aids in differentiating from pituitary adenomas.
• Accurate intraoperative recognition prevents misdiagnosis and overly aggressive surgical management.
• This finding expands the understanding of Rathke's cleft cyst pathogenesis.