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Howard M. Eisenberg, Mohammed Sarwar and Sydney Schochet Jr.

S ymptomatic Rathke's cleft cysts may be confined to the sella turcica or extend upward into the suprasellar space. Like the more common cystic tumor of this region, the craniopharyngioma, they produce symptoms by compression of surrounding structures, most frequently the pituitary, hypothalamus, and optic nerves and chiasm. Although these two cystic lesions produce similar clinical pictures, their intraoperative differentiation is important because of differences in operative management. A case of Rathke's cleft cyst is described, and its clinical

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Symptomatic Rathke's cleft cysts

Report of two cases

Gary K. Steinberg, George H. Koenig and James B. Golden

R athke's cleft cysts are intrasellar cysts lined by cuboidal or columnar epithelium, often with cilia and goblet cells. 5, 15, 32, 42 Although autopsy studies suggest that asymptomatic Rathke's cleft cysts are relatively common, 3, 21, 34, 35 the occurrence of these symptom-producing cysts are believed to be rare. Only 61 cases of symptomatic Rathke's cleft cysts have been reported in the literature. 1, 4, 6, 11–17, 19, 20, 22, 23, 29, 33, 37–39, 41, 42 Rathke's cleft cysts may become symptomatic when they enlarge to compress surrounding structures

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Symptomatic Rathke's cleft cyst

Morphological study with light and electron microscopy and tissue culture

Jun Yoshida, Tatsuya Kobayashi, Naoki Kageyama and Masaki Kanzaki

I t is widely believed that epithelial cysts found within the sella turcica are derived from remnants of Rathke's pouch. These are reported as Rathke's cleft cysts. 2, 3, 5, 6, 8, 9, 12, 13, 21 Others, however, have described them as pituitary, 1, 18, 19, 29, 30 colloid, 22 or intrasellar epithelial cysts. 7, 10, 26 According to Gillman 11 and Shanklin, 26, 27 these cysts are found in 13% to 22% of normal pituitary glands between the pars anterior and the infundibular process. In general they are less than 3 mm in diameter and are usually clinically

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Theodore G. Obenchain and Donald P. Becker

R athke's cleft cysts and infections in the region of the pituitary gland are both rare entities. To our knowledge there are no previous reports of abscess formation within a Rathke's cleft cyst. Case Report This 50-year-old woman was admitted to the Harbor General Hospital on February 18, 1970, with severe bifrontal headaches of 3 years' duration. The patient's headaches lasted from 1 to 4 days and were associated with nausea, vomiting, and generalized malaise. The temperature was elevated during the periods of headache to 102°F but would resolve

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Neurosurgical Forum: Letters to the Editor To The Editor Mario Francesco Fraioli , M.D. Filiberto Contratti , M.D. Chiara Fraioli , M.D. University of Rome Rome, Italy 389 390 Object. Microscopic Rathke cleft cysts are a common incidental autopsy finding, but some Rathke cleft cysts can become sufficiently large to cause visual impairment, hypothalamic—pituitary dysfunction, and headaches. In this study patients were evaluated pre- and postoperatively to ascertain the clinical

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Jun Fan, Songtao Qi, Yuping Peng, Xi-an Zhang, Binghui Qiu and Jun Pan

Gardner-Robertson Class II at 3 months after surgery. The most recent 64-month follow-up MRI study did not show any evidence of cyst recurrence ( Fig. 4 ). F ig . 4. Follow-up MRI at 64 months after surgery showed no cyst recurrence. A: Axial T2-weighted MR image. B: Axial Gd-enhanced image. C: Coronal Gd-enhanced image. Discussion Rathke's cleft cysts are benign, epithelium-lined cysts filled with mucous or caseous material. These cysts are thought to arise from the remnants of Rathke's pouch during the embryological migration. They are regarded

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Ahmed K. Alomari, Brian J. Kelley, Eyiyemisi Damisah, Asher Marks, Pei Hui, Michael DiLuna and Alexander Vortmeyer

indicate a bimodal distribution (preteens and older adults), with the adamantinomatous cell-type variant being found in all ages while a papillary subtype is predominantly found in adults. 13 In contrast, symptomatic Rathke's cleft cyst (RCC) is a less common lesion and represents a separate entity composed of benign enlarging remnants of the craniopharyngeal duct or Rathke's pouch. 19 The suggestion that these ectodermal lesions potentially represent a continuum has gained more popularity over the last 2 decades in an attempt to explain the occurrence of rare lesions

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Wei X. Huff, José M. Bonnin and Daniel H. Fulkerson

V on Hippel-Lindau disease (VHLD) is an inherited, autosomal dominant cancer syndrome caused by mutations of the VHL tumor suppressor gene. Patients with VHLD are predisposed to the formation of multiple CNS and visceral tumors. Rathke's cleft cysts are benign, cystic sellar lesions that are remnants of the embryological stomodeum. These cysts are not generally associated with VHLD. In this report, we present twin sisters with Rathke's cleft cysts and Type 2C VHLD. One sister required surgery for acute monocular vision loss, allowing pathological diagnosis

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Edwin G. Fischer, Umberto DeGirolami and James N. Suojanen

D elayed chiasmal syndromes have been reported after radiation therapy or excision of pituitary macroadenomas, transsphenoidal hypophysectomy for breast cancer, and antibiotic treatment of tuberculous meningitis. 2–7, 9 We report this phenomenon after surgical emptying of a Rathke's cleft cyst. Scarring extending from the chiasm to the diaphragma sellae was demonstrated by magnetic resonance imaging; neither the chiasm nor the diaphragm was displaced into the sella. Vision improved promptly after resection of the diaphragm adjacent to the scar. Case

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Yutaka Hayashi, Junkoh Yamashita, Naoki Muramatsu, Kazushige Sakuda and Hisashi Nitta

The authors report the occurrence of symptomatic Rathke's cleft cyst in 22-year-old identical twin sisters. A variable number of tandem repeat analyses revealed almost complete genetic identity between the twins (> 99.99%; Fig. 1 ). The patients both presented with persistent dull headaches, and in each case the cyst was large enough to compress the diaphragma sellae. The diagnosis was confirmed by magnetic resonance imaging, surgical excision, and histological examination. Magnetic resonance imaging revealed the cysts to be of high intensity on the T 1