Rathke's Cleft Cysts

Rathke's Cleft Cysts, also known as Rathke's Cysts, is a benign growth that is formed from Ratheke’s pouch. Ratheke’s pouch is part of the embryological development which ultimately creates the pituitary glad. When the pouch doesn’t close properly, which it does in normal fetal development, the remainder can continue as a cleft in the pituitary gland. In some cases this cleft can cause a large cyst which is called Rathke's Cleft Cyst.


These cysts exist in between the anterior and posterior lobes of the pituitary gland. They are usually filled with fluids in a range of viscosities, from watery to a gelatinous consistency and can vary in color.


Rathke's Cleft Cysts are more frequent among females and occur in people in all ages.

In most cases these cysts are asymptomatic to do not cause any problems for those with the cyst. In these instances the cysts are found incidentally when patients are have radiographic imaging taken for other unrelated issues. The cysts that cause symptoms for patients are often rather large and cause problems resulting form increased pressure on the pituitary gland, pituitary stalk, optic chasm or the hypothalamus. The compression can produce headache and vision problems, such as a reduced visual field. The pressure on the hypothalamus can cause the endocrine system to not function properly and result in diabetes insipidus, ameorrhea and galactorrhea in women, low libido in men,  or panhypopituitarism. In rare cases seizures can be a consequence of the cyst.

A diagnosis is usually made when patients have problems with vision or dysfunctions with their endocrine system as a result from pressure by the cyst.


The most common way to diagnose Rathke's Cleft Cysts is an MRI used with contrast. A CT scan is also used to evaluate the structure of the cyst do determine if the cyst is has any  calcification. Figuring out if the cyst has calcium in it is crucial in the diagnosis as the cysts it can often be diagnosed as craniophyarngioma, although there are some cases of Rathke's Cleft Cyst that contain calcium.


Although imaging can help to make a diagnosis, the scans cannot be soley used to distinguish between arachnoid cysts and epidormoids. In order to make a definitive diagnosis clinical and pathological findings must also be analyzed.


Many people live with Rathke’s Cleft Cyst without having any problems or symptoms. In these cases, often the cyst is never discovered and no treatment is needed. For the patients who have symptoms as a result of the cyst then surgical removal and draining the cyst is necessary. The surgery for this is minimally invasive and done through the nasal passage, also known as endonasal transsphenoidal. The cyst can be completely removed in 80% - 90% of cases. When the  These benign cysts do not require any radiation as treatment.


As with most masses in the brain, early detection and treatment aids in the best possible outcome. The cyst return in about 5% - 15% of cases and are usually occur within 5 -10 years of the removal. Once the cyst is removed their symptoms often impove or fade away completely. For some patients with visual impairment their vision may not be completely restored.

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