Symptomatic Rathke's cleft cyst simulating arachnoid cyst--case report

Area of Science:

• Neuroimaging
• Neuropathology
• Endocrinology

Background:

• Rathke's cleft cysts (RCCs) are typically benign intracranial cysts.
• Symptomatic RCCs can present with diverse neurological symptoms.
• Distinguishing RCCs from other cystic lesions, like arachnoid cysts, is crucial for diagnosis.

Observation:

• A case presented with symptoms mimicking an arachnoid cyst.
• Computed tomography and magnetic resonance imaging revealed cyst content similar to cerebrospinal fluid.
• Faint contrast enhancement was noted in a portion of the cyst wall.

Findings:

• Histological examination suggested vascular connective tissue and nests of pituitary cells contributed to the observed contrast enhancement.
• This finding challenges typical imaging characteristics of Rathke's cleft cysts.
• The cyst's presentation mimicked an arachnoid cyst despite distinct histological features.

Implications:

• This case highlights the importance of considering Rathke's cleft cysts in the differential diagnosis of sellar/suprasellar cystic lesions.
• Further clinical and neuroradiological studies are warranted to better understand and diagnose these specific types of Rathke's cleft cysts.
• Accurate diagnosis is essential for appropriate management and patient outcomes in neurosurgery and endocrinology.