Rathke cleft cyst

Case contributed by Ryan Thibodeau
Diagnosis almost certain


Low testosterone. Evaluate for pituitary pathology.

Patient Data

Age: 40 years
Gender: Male

There is a well-circumscribed nonenhancing CSF intensity cyst within the ventral aspect of the anterior pituitary gland which measures 7 x 6 x 6 mm (TRV, AP, CC). The remainder of the pituitary gland displays normal homogeneous enhancement and the pituitary infundibulum is midline. The posterior pituitary bright spot is present, and in normal location.

Case Discussion

Given the imaging appearance (CSF intensity in ventral pituitary), this lesion likely represents a Rathke cleft cyst. The patient was also incidentally found to have right cerebellar ectopia.

The patient has been following up with endocrinology as an outpatient. Surgery is planned due to the symptomatic nature of the lesion.

Alannah McCann
Ananth Narayan, MD

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