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J Neurol Surg A Cent Eur Neurosurg 2013; 74(S 01): e229-e232
DOI: 10.1055/s-0033-1343985
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Ruptured Rathke Cleft Cyst Mimicking Pituitary Apoplexy

Marian Christoph Neidert
1   Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
,
Christoph Michael Woernle
1   Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
,
Henning Leske
2   Department of Neuropathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
,
Diane Möller-Goede
4   Division of Endocrinology and Diabetes, University Hospital Zurich, University of Zurich, Zurich, Switzerland
,
Athina Pangalu
3   Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
,
Christoph Schmid
4   Division of Endocrinology and Diabetes, University Hospital Zurich, University of Zurich, Zurich, Switzerland
,
René-Ludwig Bernays
1   Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
› Author Affiliations
Further Information

Publication History

24 October 2012

11 February 2013

Publication Date:
21 May 2013 (online)

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Abstract

Rathke cleft cysts (RCCs) are benign cystic lesions of the sellar and suprasellar region that are asymptomatic in most cases. Occasionally, compression of the optic pathway and hypothalamo-pituitary structures may cause clinical symptoms, such as headaches, visual deficits and endocrinopathies. Acute presentation caused by hemorrhage into an RCC have been described in the literature, and the term “Rathke cleft cyst apoplexy” has been coined. We present the case of a 32-year-old man with acute onset of meningitis-type symptoms and imaging findings resembling hemorrhagic pituitary tumor apoplexy. In retrospect, clinical symptoms, intraoperative appearance, and histologic examination were compatible with the diagnosis of nonhemorrhagic rupture of an RCC. Thus, the clinical presentation of “Rathke cleft cyst apoplexy” is not necessarily caused by hemorrhage.

Keywords

Rathke cleft cyst - pituitary apoplexy - sellar mass - RCC rupture - nonhemorrhagic RCC apoplexy
 

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