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Abscess formation within a Rathke's cleft cyst

Ian C Coulter1, Sajedha Mahmood2, David Scoones3

  • 1Department of Neurosurgery, James Cook University Hospital, Middlesbrough, UK ian.coulter@doctors.org.uk.

Journal of Surgical Case Reports
|November 8, 2014
PubMed

Insights

This rare case highlights a pituitary abscess within a Rathke's cleft cyst (RCC). Prompt treatment with antibiotics and surgery led to successful recovery, emphasizing RCC abscess as a crucial differential diagnosis for pituitary masses.

Area of Science:

  • Endocrinology
  • Neurosurgery
  • Pathology

Background:

  • Rathke's cleft cysts (RCC) are common sellar region cysts, typically benign.
  • Pituitary abscesses are rare but serious infections within the pituitary gland.
  • Differentiating between RCC and pituitary abscess preoperatively can be challenging.

Observation:

  • A 66-year-old male presented with visual decline and hypopituitarism symptoms.
  • Imaging revealed a pituitary mass, leading to transsphenoidal debulking.
  • Purulent material was discovered intraoperatively, with histological analysis confirming RCC and abscess.

Findings:

  • Microbiological culture identified Staphylococcus aureus as the causative agent.
  • The patient received a course of antibiotics and endocrine replacement therapy.
  • Histopathology confirmed both Rathke's cleft cyst and abscess features.

Implications:

  • This case underscores the importance of considering pituitary abscess in the differential diagnosis of pituitary masses.
  • Clinical presentation and radiological findings for RCC and pituitary abscess can overlap significantly.
  • Early recognition and appropriate management, including antibiotics and surgical decompression, are vital for favorable outcomes.

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