Rathke's Cleft Cyst Abscess with a Very Unusual Course

Amy Coulden; Joshua Pepper; Agata Juszczak; Ruchika Batra; Swarupsinh Chavda; Latha Senthil; John Ayuk; Ute Pohl; Santhosh Nagaraju; Niki Karavitaki; Georgios Tsermoulas

doi:10.1055/s-0042-1750798

Asian Journal of Neurosurgery, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Asian J Neurosurg 2022; 17(03): 527-531
DOI: 10.1055/s-0042-1750798

Case Report

Rathke's Cleft Cyst Abscess with a Very Unusual Course

Authors

Amy Coulden

¹Department of Endocrinology, Queen Elizabeth Hospital, Birmingham, United Kingdom

²Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, United Kingdom

³Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
Joshua Pepper

⁴Department of Neurosurgery, Queen Elizabeth Hospital, Birmingham, United Kingdom
Agata Juszczak

⁵Department of Endocrinology, Birmingham Heartlands Hospital, Birmingham, United Kingdom
Ruchika Batra

⁶Department of Ophthalmology, Queen Elizabeth Hospital, Birmingham, United Kingdom
Swarupsinh Chavda

⁷Department of Radiology, Queen Elizabeth Hospital, Birmingham, United Kingdom
Latha Senthil

⁷Department of Radiology, Queen Elizabeth Hospital, Birmingham, United Kingdom
John Ayuk

¹Department of Endocrinology, Queen Elizabeth Hospital, Birmingham, United Kingdom

³Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
Ute Pohl

⁸Department of Cellular Pathology, Queen Elizabeth Hospital, Birmingham, United Kingdom
Santhosh Nagaraju

⁸Department of Cellular Pathology, Queen Elizabeth Hospital, Birmingham, United Kingdom
Niki Karavitaki

¹Department of Endocrinology, Queen Elizabeth Hospital, Birmingham, United Kingdom

²Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, United Kingdom

³Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
Georgios Tsermoulas

²Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, United Kingdom

⁴Department of Neurosurgery, Queen Elizabeth Hospital, Birmingham, United Kingdom

Abstract

Infected Rathke's cleft cysts (RCC) are extremely rare with only a few published cases. We report the case of a 31-year-old man who presented with headaches, visual disturbance, and hypopituitarism secondary to an infected RCC with extension of abscesses along the optic tract. Magnetic resonance imaging showed ring enhancing cystic lesions within an expanded sella with suprasellar and intraparenchymal extension. The radiological appearance suggested a high-grade optic glioma, but an endoscopic transsphenoidal biopsy revealed frank pus in the pituitary fossa, which subsequently grew Staphylococcus aureus. Pathological examination of the cyst wall showed an inflamed RCC. Following a prolonged course of intravenous antibiotics, the infection resolved and vision improved. RCC abscesses are rare and the intracranial extension of the infection in our case makes it unique.

Keywords

Rathke's cleft cyst - pituitary abscess - transphenoidal surgery

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Referenzen

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