Presentation
Headache with vomiting.
Patient Data
Age: 20 years
Gender: Female
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Hyperdense lesion within the pituitary gland. No suprasellar extension or remodeling of the pituitary fossa.
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Lesion identified right of the midline within the pituitary fossa measuring 10 mm. This is intermediate to high signal on T1 with no contrast enhancement. On sagittal imaging and intracystic high T1 signal "dot" is seen. No suprasellar extension to the optic chiasma.
Case Discussion
This case most likely represents a Rathke cleft cyst. The main differential is that of a small hemorrhagic adenoma, although the presence of an intracystic high T1 signal 'dot' argues strongly in favor of a Rathke's cleft cyst. Follow-up imaging will confirm the diagnosis.
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