Journal List > J Korean Soc Radiol > v.65(5) > 1087028

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Choo, Choi, Jung, Kim, Jeun, Hong, and Ahn: A Rathke's Cleft Cyst with Chronic Inflammation Mimicking a Pituitary Macroadenoma
Neuroradiology
Case Report

Journal of the Korean Society of Radiology 2011; 65(5): 451-454.

Published online: 30 November 2011

DOI: https://doi.org/10.3348/jksr.2011.65.5.451

A Rathke's Cleft Cyst with Chronic Inflammation Mimicking a Pituitary Macroadenoma

Ka Yeon Choo, MD1, Hyun Seok Choi, MD1, So Lyung Jung, MD1, Bum soo Kim, MD1, Sin Soo Jeun, MD2, Yong Kil Hong, MD2, Kook Jin Ahn, MD1

1Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

2Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

Corresponding author: Kook-Jin Ahn, MD. Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea. Tel. 82-2-2258-1441, Fax. 82-2-599-6771, ahn-kj@catholic.ac.kr

Received 25 June 2011       Accepted 24 August 2011

Copyright © 2011 The Korean Society of Radiology

Abstract

Rathke's cleft cyst is a benign cystic lesion arising in the sellar or suprasellar region. Most cases of Rathke's cleft cysts are thin-walled cystic lesions, but in rare cases, can cause a pituitary abscess by inflammation or infection. We report on a case of Rathke's cleft cyst with chronic inflammation mimicking a pituitary macroadenoma seen as a thick-walled irregular cystic lesion on brain CT and MRI.

Keywords: Rathke's Cleft Cyst, Brain MRI

Figures and Tables

Fig. 1

CT on admission.

A, B. Contrast enhanced CT images show well defined cystic mass (arrow) in the sellar and suprasellar areas with asymmetric thick rim enhancement.
jksr-65-451-g001
Fig. 2

MRI on admission.

A. T1-weighted sagittal image shows cystic mass (arrow) in the sellar and suprasellar area. Normal or compressed pituitary gland is not detected.
B. T2-weighted coronal image shows intermediate signal intensity mass (arrow) with internal cystic component, similar signal to the CSF.
D. Contrast enhanced T1-weighted axial and coronal images show thick rim enhancement of the peripheral solid portion of the mass (arrow).
Note.-CSF = cerebrospinal fluid
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Fig. 3

Microscopic finding shows lining epithelium consisting of cuboidal or flat cells with subepithelial inflammatory cell infiltration including lymphocytes and histiocytes.

jksr-65-451-g003

References

1. Bognàr L, Szeifert GT, Fedorcsàk I, Pàsztor E. Abscess formation in Rathke's cleft cyst. Acta Neurochir (Wien). 1992; 117:70–72.
2. Sato M, Matsushima Y, Taguchi J, Matsumoto S, Tatsumi C, Ozaki M, et al. [A case of pituitary abscess caused by infection of Rathke's cleft cyst]. No Shinkei Geka. 1995; 23:991–995.
3. Brassier G, Morandi X, Tayiar E, Riffaud L, Chabert E, Heresbach N, et al. Rathke's cleft cysts: surgical-MRI correlation in 16 symptomatic cases. J Neuroradiol. 1999; 26:162–171.
4. Rhee JJ, Kim JH, Kim CJ, Lee JK, Jung HW. Radiological characteristics in Rathke's cleft cyst. J Korean Neurosurg Soc. 2003; 34:140–145.
5. Naylor MF, Scheithauer BW, Forbes GS, Tomlinson FH, Young WF. Rathke cleft cyst: CT, MR, and pathology of 23 cases. J Comput Assist Tomogr. 1995; 19:853–859.
6. Voelker JL, Campbell RL, Muller J. Clinical, radiographic, and pathological features of symptomatic Rathke's cleft cysts. J Neurosurg. 1991; 74:535–544.
7. Ciappetta P, Calace A, D'Urso PI, De Candia N. Endoscopic treatment of pituitary abscess: two case reports and literature review. Neurosurg Rev. 2008; 31:237–246. discussion 246.
8. Domingue JN, Wilson CB. Pituitary abscesses. Report of seven cases and review of the literature. J Neurosurg. 1977; 46:601–608.
9. Jain KC, Varma A, Mahapatra AK. Pituitary abscess: a series of six cases. Br J Neurosurg. 1997; 11:139–143.
10. Takao H, Doi I, Watanabe T. Diffusion-weighted magnetic resonance imaging in pituitary abscess. J Comput Assist Tomogr. 2006; 30:514–516.
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