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Rathke cleft cyst masquerading as pituitary abscess: A case report
Chengxian Yang1, Xinjie Bao, Xiaohai Liu
1Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
Medicine
|March 9, 2017
Summary
Rathke cleft cyst (RCC) can mimic pituitary abscess, presenting with similar symptoms and imaging. Accurate diagnosis requires vigilance and histopathological confirmation to differentiate these sellar lesions.
Area of Science:
- Endocrinology
- Neurosurgery
- Pathology
Background:
- Rathke cleft cyst (RCC) is a rare sellar cystic lesion, typically small and asymptomatic.
- When presenting with panhypopituitarism and cystic sellar lesions with rim enhancement, RCC is exceptionally rare.
- Clinical and imaging similarities can lead to misdiagnosis as pituitary abscess.
Observation:
- A 62-year-old male presented with headache, visual deficits, and symptoms of panhypopituitarism.
- MRI revealed a sellar lesion with cystic changes and rim enhancement, initially suggesting pituitary abscess.
- Histopathology confirmed Rathke cleft cyst, with no evidence of infection or abscess.
Findings:
- The patient exhibited severe hyponatremia and panhypopituitarism.
- Trans-sphenoidal surgery was performed after hormone replacement therapy.
- Histopathological examination ruled out abscess, identifying Rathke cleft cyst.
Implications:
- This case highlights the importance of considering Rathke cleft cyst in the differential diagnosis of sellar lesions.
- Vigilance in differentiating RCC from pituitary abscess is crucial due to overlapping clinical and radiological features.
- Accurate histopathological analysis is essential for definitive diagnosis and appropriate management of sellar cystic lesions.
