Presentation
Primary infertility and galactorrhea.
Patient Data
A well-defined abnormal signal intensity mass lesion (hyperintense on T2WI, isointense on T1WI, without post contrast enhancement) in the right half of pituitary gland measuring 10 x 10 x 12 mm in size. No invasion of adjacent infiltrative or inflammatory changes.
Case Discussion
The differential diagnosis of the above features can be cystic pituitary adenoma and Rathke cleft cyst.
A study on the differentiation between cystic pituitary adenomas and Rathke cleft cyst 1 concluded that the presence of a fluid-fluid level, a hypointense rim on T2-weighted images, septation, and an off-midline location are more common with pituitary adenomas, while an intracystic nodule is more common in Rathke cleft cysts.
Here in this case; the off-midline location is in favor of adenoma while the absence of septation, fluid-fluid level and hypointense rim make the possibility of Rathke's cleft cyst more likely.