A Rathke's Cleft Cyst Presenting with Apoplexy
1Department of Neurosurgery, Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea.
Journal of Korean Neurosurgical Society
|November 8, 2012
Summary
Symptomatic pituitary hemorrhage into a Rathke's cleft cyst (RCC) is rare. This case demonstrates successful transsphenoidal drainage resolving symptoms of pituitary apoplexy.
Area of Science:
- Neuroendocrinology
- Neurosurgery
- Endocrinology
Background:
- Rathke's cleft cysts (RCCs) are typically benign intrasellar or suprasellar cysts.
- Pituitary apoplexy is a clinical syndrome caused by pituitary infarction or hemorrhage.
- Hemorrhage into an RCC is an exceptionally rare event.
Observation:
- A 62-year-old woman presented with acute headache, confusion, and partial hypopituitarism.
- Magnetic resonance imaging suggested a hemorrhagic pituitary adenoma.
- The patient had an intra- and suprasellar Rathke's cleft cyst.
Findings:
- Transsphenoidal drainage of the cyst contents confirmed a hemorrhagic RCC.
- The patient's symptoms resolved following cyst decompression.
- This case highlights a rare presentation of pituitary apoplexy secondary to RCC hemorrhage.
Implications:
- Hemorrhagic RCC should be considered in the differential diagnosis of pituitary apoplexy.
- Transsphenoidal surgery is an effective treatment for symptomatic hemorrhagic RCC.
- Further research is needed to understand the pathogenesis of hemorrhage in RCCs.
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