[Pituitary non adenomatous tumor (Rathke's cleft cyst)]

Rathke's cleft cyst is one of many kinds of pituitary non-adenomatous tumors. Rathke's cleft cysts were evidenced by surgery in 7 cases from 7 to 87 years old. After the era of CT scan and MRI some cases were found incidentally after the head injury. Symptoms and signs of cases with Rathke's cleft cyst were headache, visual disturbances and/or diabetes insipidus. The lesion was high density on plain CT images and showed no-enhancement. The lesion on 2/3 cases showed high intensity on T1 weighted images and the others low. The lesion in half showed iso-intensity on T2 weighted images and in other half high intensity. The stalk was deviated to lateral side in a case. Half lesion was in the sella and half was in supra-sellar region. The cyst was present in both intra-sellar and supra-sellar region in a case and showed a dumb-bell type. There are three approaches for removal of Rathke's cleft cyst. Hardy's transnasal approach was used on intrasellar type. The trans-Sylvian or anterior trans-interhemispheric approach was used on supra-sellar type. Content in the cyst was evacuated totally, and the cyst wall was removed as much as possible. However, the stalk should be protected from damage.