[Rathke's cleft cyst. Report of two cases]

Two cases of Rathke's cleft cysts were reported. Case 1. A 57-year-old man was admitted to our hospital on Sep. 29th. 1982, complaining of visual field defect. Visual acuity was 0.7 in the left eye and 0.1 in the right eye. Visual field examination revealed upper temporal quadrantanopsia on the left side and incomplete temporal hemianopia on the right side. He was neurologically free otherwise. Endocrinological study disclosed general hypopituitarism except for elevated serum prolactin level. CT scan showed a high density mass in the enlarged sellar cavity extending to suprasellar area. Right frontal craniotomy was performed on Oct. 26th, 1982, and about 3 ml of reddish-brown colloid substance was aspirated and the capsule of the cyst was excised. Postoperative course was uneventful. The visual acuity and field defects were improved. Microscopic section of the cyst demonstrated a loose fibrous wall, lined by single layer of ciliated columnar epithelial cells containing secreting vesicles. Histological diagnosis was Rathke's cleft cyst. Case 2. A 43-year-old female was attacked by subarachnoid hemorrhage on Jan. 1st, 1983. Angiography revealed an anterior communicating aneurysm. Operation was performed on Jan. 18th, 1983 and the aneurysm was successfully clipped. During surgery a suprasellar cystic mass was incidentally discovered and the cyst wall was resected. Microscopic section of the cyst demonstrated one layer of cuboidal cells supported by thick connective tissue. Precise check of her early history disclosed that her menstruation had been delayed and visual acuity had been impaired. CT scan was negative as far as the suprasellar region was concerned.