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T2 hypointense Rathke cleft cyst

Case contributed by Dr Roberto Schubert

Presentation:

Known avascular lesion in the sella turcica followed with MRI for more than 4 years.

Patient Data:

Age: 41
Gender: Male
Race: Middle eastern
Modality: MRI

Interestingly, besides the T2 hypo and T1 hyperintense Rathke cyst, which does not enhance, there is also a Thornwaldt cyst in the epipharynx. Both Rathke's pouch and Thornwaldt cysts (epipharyngeal bursae) are closely related to the chorda dorsalis during embryogenesis.

MRI - 4 years earlier

Modality: MRI

T2 hypointense and T1 hyperintense lesion in the sella, anterior to the neurohypophysis, which also shows T1-hyperintense (but not T2 hypointense) signal.

Case Discussion:

T2 hypointensity in a pituitary cyst is regarded as highly suggestive of a Rathke cleft cyst 1.

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