J Korean Neurosurg Soc.  2012 Aug;52(2):152-155. 10.3340/jkns.2012.52.2.152.

A Case of Ectopic Rathke's Cleft Cyst in the Prepontine Cistern

• Kim E

• KMID: 2190556
• DOI: http://doi.org/10.3340/jkns.2012.52.2.152

Abstract

A Rathke's cleft cyst (RCC) is a benign pituitary cyst derived from the remnant of Rathke's pouch, and usually presents as an intrasellar lesion with varying degrees of suprasellar extension. However, to date, a description of a primary prepontine RCC with no intrasellar component has not been reported. The author describes an exceptional case of a symptomatic RCC located behind the sella turcica in a 41-year-old woman who presented with severe headache. The author also provides an embryological hypothesis of the development of an ectopic RCC, with a special emphasis on radiologic characteristics.

Keyword

Prepontine cistern; Rathke's pouch; Rathke's cleft cyst; Sella turcica; Suprasellar cyst

MeSH Terms

Adult
Central Nervous System Cysts
Female
Headache
Humans
Sella Turcica

Figure

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  Fig. 1 Neuroimaging studies of an ectopic Rathke's cleft cyst. Computed tomography scans show a homogenous oval-shaped high density in the prepontine cistern. Magnetic resonance images depict a nonenhancing retrosellar mass with an intracystic nodule that displays iso- to slight hyperintensity on T1-weighted sequence and hypointensity on T2-weighted sequence. The nodule (*) is surrounded by thin isointense cyst fluid (arrow).

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  Fig. 2 Operative and pathology features of a Rathke's cleft cyst in the prepontine cistern. Intraoperative view demonstrates resection of a cyst wall with thick mucoid and white-yellow substances (A). Photomicrographs of surgical specimens show the cystic contents and the waxy nodules (B and C). Histopathological examination of cyst wall illustrates ciliated columnar epitheliums and inflammatory infiltrates (H&E, original magnification ×100) (D).

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  Fig. 3 Postoperative computed tomography scans exhibit disappearance of the hyperdense cyst behind the pituitary fossa.

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