[Intrasellar abscess into a cyst of the Rathke's pouch (authors' translation)]

The authors report a case of abscessified cyst the pouch of Rathke similar to that published by Obenchain in 1972 and Menault in 1979. The clinical picture was determined for recurrent meningeal burst without signs of intracraneal pressure nor optochiasmatic involvement. The spinal fluid showed pleocitosis and hyperprotein. No bacterial growth was demonstrated. Antibiotic therapy had no effect on the clinical follow-up. C.T. was unable to show the location of the lesion evidenced by pneumocisternography. Though a subfrontal approach was emptied an abscess in the sella turcica, with walls formed for tissue of he Rathke's pouch. A few months later a new meningeal burst occurred and a recurrence of the abscess was confirmed at operation. The follow-up was of progressive neurological deterioration with exitus letalis a few days later. Abscessified sella tumors ahd been rarely reported in the literature : chromophobe adenoma appeared most frequently and only in 3 cases within craniopharyngiomas. Diagnostic difficulties arise from the lack of focal symptoms and from the failure of some neuroradiological procedures to demonstrate the lesion. The high risk of recurrence and the poor prognosis of these abscess will be discused. Although a similar embryological origin the cyst the Rathke's cleft and the craniopharingiomas present pathological aspects that made each other differenciable.