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Rathke's cleft cyst - large dot sign

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Stable over 5 years

Patient Data

Age: 55 years
Gender: Female

Appearances are unaltered. A cystic lesion mostly fills the pituitary fossa and bulges into the suprasellar cistern and not compressing or distorting the optic chiasm. It measures 17 x 10 by 11 mm, unaltered when compared to previous imaging, it continues to have a T1 hyperintensity and T2 hypointense (previous imaging) nodule posteroinferiorly within the cyst, which does not enhance. The remainder of the imaged brain (please note this study has been targeted to the pituitary, and as such the whole brain has not been imaged) appears unremarkable.

Conclusion:

Stable appearances when compared to previous imaging, and remain most consistent with a Rathke's cleft cyst. Particularly the luminal nodule, although unusually large, is quite characteristic.

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