Rathke's cleft cyst

Case contributed by Dr Luu Hanh

Presentation

Headache

Patient Data

Age: 30 years
Gender: Female
MRI

There is a well-defined mass centered in the sellar and suprasellar region, not compressing the optic chiasm, no extension into the adjacent cavernous sinuses. It elicits a hyperintense signal on T2/FLAIR, an isointense signal on T1, no restricted diffusion on DWI, and no enhancement in the post-contrast study apart from the peripheral thin enhancing rim. 
The mass is seen in midline location, no identified septations, fluid-fluid levels, and hypointense rim on T2. 

Case Discussion

MRI findings represent predominantly cystic pituitary region mass, likely cystic pituitary adenoma or Rathke cleft cyst.

The midline location and absence of septations, fluid-fluid levels, and hypointense rim on T2 favor the Rathke cleft cyst rather than the cystic pituitary adenoma 1.

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