Rathke's cleft cyst

Case contributed by Saad Ahmed Saad Hassan



Patient Data

Age: 50 years
Gender: Female

A midline cystic lesion, measuring 16x9x8 mm, is seen involving the pituitary gland. An intracystic tiny nodule involves the left anterior inferior aspect of the cyst. Posterior to this nodule, there is a septation involving the left aspect of the cyst. There is peripheral enhancement of the cyst which could be related to the compressed pituitary tissue. The lesion causes upward convexity of the pituitary, however, there is no mass effect on the optic chiasm. There is no extension into the adjacent cavernous sinuses. No fluid-fluid level could be detected within the cyst.

Annotated image

Selected axial and coronal T2WI demonstrate the isointense intracystic nodule (white arrows).

Case Discussion

MRI findings are consistent with Rathke's cleft cyst (RCC). The main differential diagnosis is cystic pituitary adenoma.

Findings in favor of Rathke's cleft cyst:

  • an intracystic nodule (highly suggestive)
  • midline location within the gland
  • no fluid-fluid level
  • no septation (in this case, there is a septation, however, the midline location and intracystic nodule favor the diagnosis of Rathke's cleft cyst

Findings in favor of cystic pituitary adenoma:

  • off-midline location
  • a fluid-fluid level
  • septations

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.