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Intrasphenoidal Rathke Cleft Cyst: A Rare Case Report
Mahadevan S Gowtham1, Devaraj Sunilkumar1, Andi S Ramesh2
1Department of Radio-Diagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
Journal of Pediatric Neurosciences
|December 19, 2022
Summary
Rathke cleft cysts are rare benign sellar lesions. This case highlights an intrasphenoidal Rathke cleft cyst in a teen presenting with headache and visual issues.
Area of Science:
- Neurosurgery
- Endocrinology
- Ophthalmology
Background:
- Rathke cleft cysts (RCCs) are benign cystic lesions originating from remnants of the Rathke pouch, typically located in the sellar or suprasellar regions.
- Intrasphenoidal RCCs, those primarily within the sphenoid sinus, are exceptionally rare, particularly in pediatric populations.
Observation:
- A 15-year-old female presented with headache and visual disturbances, indicative of sellar/suprasellar mass effect.
- Neuroimaging revealed an expansile cystic lesion within the sphenoid sinus, causing significant mass effect on the pituitary gland and optic chiasma.
Findings:
- Endoscopic decompression was successfully performed for the intrasphenoidal cystic lesion.
- Histopathological examination confirmed the diagnosis of a Rathke cleft cyst.
- Post-operative MRI demonstrated complete resection of the cyst, though partial left optic nerve atrophy persisted.
Implications:
- This case expands the understanding of rare intrasphenoidal Rathke cleft cyst presentations in adolescents.
- Highlights the importance of considering RCCs in the differential diagnosis of sellar/suprasellar masses with atypical locations.
- Demonstrates the efficacy of endoscopic surgical approaches for intrasphenoidal lesions and underscores the potential for visual sequelae despite successful resection.
