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Rathke Cleft Cyst
Karen L. Salzman, MD; Anne G. Osborn, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Rathke cleft cyst (RCC)
          • Definitions

            • Nonneoplastic cyst arising from remnants of embryonic Rathke cleft
            • Benign, sellar region endodermal cyst lined by ciliated, mucus-producing epithelium

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Agarwalla PK et al: Stereotactic radiation as salvage therapy for recurrent Rathke cleft cysts. Neurosurgery. ePub, 2020
                                      2. Azuma M et al: Usefulness of contrast-enhanced 3D-FLAIR MR imaging for differentiating Rathke cleft cyst from cystic craniopharyngioma. AJNR Am J Neuroradiol. 41(1):106-10, 2020
                                      3. Ijare OB et al: Proton magnetic resonance spectroscopy characterization of Rathke's cleft cysts (RCCs): Relevance to the differential diagnosis of pituitary adenomas and RCCs. Cancers (Basel). 12(2), 2020
                                      4. Jung HN et al: Rathke cleft cysts with apoplexy-like symptoms: Clinicoradiologic comparisons with pituitary adenomas with apoplexy. World Neurosurg. ePub, 2020
                                      5. Barkhoudarian G et al: Rathke's cleft cysts: a 6-year experience of surgery vs. observation with comparative volumetric analysis. Pituitary. 22(4):362-71, 2019
                                      6. Mahdi ES et al: Prevalence of pituitary cysts in children using modern magnetic resonance imaging techniques. Pediatr Radiol. 49(13):1781-7, 2019
                                      7. Doknic M et al: Single center study of 53 consecutive patients with pituitary stalk lesions. Pituitary. 21(6):605-14, 2018
                                      8. Shepard MJ et al: Presentation and outcomes in surgically and conservatively managed pediatric Rathke cleft cysts. J Neurosurg Pediatr. 21(3):308-14, 2018
                                      9. Tang C et al: The coexistence of growth hormone-producing pituitary adenoma and Rathke cleft cyst: How can we diagnosis preoperation? J Craniofac Surg. 29(7):1887-9, 2018
                                      10. Alomari AK et al: Craniopharyngioma arising in a Rathke's cleft cyst: case report. J Neurosurg Pediatr. 15(3):250-4, 2015
                                      11. Chotai S et al: Characteristics of Rathke's cleft cyst based on cyst location with a primary focus on recurrence after resection. J Neurosurg. 1-10, 2015
                                      12. Esteves C et al: Pituitary incidentalomas: analysis of a neuroradiological cohort. Pituitary. ePub, 2015
                                      13. Han SJ et al: Rathke's cleft cysts: review of natural history and surgical outcomes. J Neurooncol. 117(2):197-203, 2014
                                      14. Ogawa Y et al: Spontaneous alteration from Rathke's cleft cyst to craniopharyngioma--possible involvement of transformation between these pathologies. Endocr Pathol. 25(4):422-6, 2014
                                      15. Oh YJ et al: Clinical and radiological findings of incidental Rathke's cleft cysts in children and adolescents. Ann Pediatr Endocrinol Metab. 19(1):20-6, 2014
                                      16. Kitajima M et al: Differentiation of common large sellar-suprasellar masses effect of artificial neural network on radiologists' diagnosis performance. Acad Radiol. 16(3):313-20, 2009
                                      17. Binning MJ et al: Hemorrhagic and nonhemorrhagic Rathke cleft cysts mimicking pituitary apoplexy. J Neurosurg. 108(1):3-8, 2008
                                      18. Glezer A et al: Rare sellar lesions. Endocrinol Metab Clin North Am. 37(1):195-211, x, 2008
                                      19. Rao VJ et al: Imaging characteristics of common suprasellar lesions with emphasis on MRI findings. Clin Radiol. 63(8):939-47, 2008
                                      20. Kunii N et al: Rathke's cleft cysts: differentiation from other cystic lesions in the pituitary fossa by use of single-shot fast spin-echo diffusion-weighted MR imaging. Acta Neurochir (Wien). 149(8):759-69; discussion 769, 2007
                                      21. Kim JE et al: Surgical treatment of symptomatic Rathke cleft cysts: clinical features and results with special attention to recurrence. J Neurosurg. 100(1):33-40, 2004
                                      22. Byun WM et al: MR imaging findings of Rathke's cleft cysts: significance of intracystic nodules. AJNR Am J Neuroradiol. 21(3):485-8, 2000
                                      23. Naylor MF et al: Rathke cleft cyst: CT, MR, and pathology of 23 cases. J Comput Assist Tomogr. 19(6):853-9, 1995
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Rathke cleft cyst (RCC)
                                              • Definitions

                                                • Nonneoplastic cyst arising from remnants of embryonic Rathke cleft
                                                • Benign, sellar region endodermal cyst lined by ciliated, mucus-producing epithelium

                                              IMAGING

                                              • General Features

                                                • CT Findings

                                                  • MR Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Gross Pathologic & Surgical Features

                                                            • Microscopic Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Agarwalla PK et al: Stereotactic radiation as salvage therapy for recurrent Rathke cleft cysts. Neurosurgery. ePub, 2020
                                                                          2. Azuma M et al: Usefulness of contrast-enhanced 3D-FLAIR MR imaging for differentiating Rathke cleft cyst from cystic craniopharyngioma. AJNR Am J Neuroradiol. 41(1):106-10, 2020
                                                                          3. Ijare OB et al: Proton magnetic resonance spectroscopy characterization of Rathke's cleft cysts (RCCs): Relevance to the differential diagnosis of pituitary adenomas and RCCs. Cancers (Basel). 12(2), 2020
                                                                          4. Jung HN et al: Rathke cleft cysts with apoplexy-like symptoms: Clinicoradiologic comparisons with pituitary adenomas with apoplexy. World Neurosurg. ePub, 2020
                                                                          5. Barkhoudarian G et al: Rathke's cleft cysts: a 6-year experience of surgery vs. observation with comparative volumetric analysis. Pituitary. 22(4):362-71, 2019
                                                                          6. Mahdi ES et al: Prevalence of pituitary cysts in children using modern magnetic resonance imaging techniques. Pediatr Radiol. 49(13):1781-7, 2019
                                                                          7. Doknic M et al: Single center study of 53 consecutive patients with pituitary stalk lesions. Pituitary. 21(6):605-14, 2018
                                                                          8. Shepard MJ et al: Presentation and outcomes in surgically and conservatively managed pediatric Rathke cleft cysts. J Neurosurg Pediatr. 21(3):308-14, 2018
                                                                          9. Tang C et al: The coexistence of growth hormone-producing pituitary adenoma and Rathke cleft cyst: How can we diagnosis preoperation? J Craniofac Surg. 29(7):1887-9, 2018
                                                                          10. Alomari AK et al: Craniopharyngioma arising in a Rathke's cleft cyst: case report. J Neurosurg Pediatr. 15(3):250-4, 2015
                                                                          11. Chotai S et al: Characteristics of Rathke's cleft cyst based on cyst location with a primary focus on recurrence after resection. J Neurosurg. 1-10, 2015
                                                                          12. Esteves C et al: Pituitary incidentalomas: analysis of a neuroradiological cohort. Pituitary. ePub, 2015
                                                                          13. Han SJ et al: Rathke's cleft cysts: review of natural history and surgical outcomes. J Neurooncol. 117(2):197-203, 2014
                                                                          14. Ogawa Y et al: Spontaneous alteration from Rathke's cleft cyst to craniopharyngioma--possible involvement of transformation between these pathologies. Endocr Pathol. 25(4):422-6, 2014
                                                                          15. Oh YJ et al: Clinical and radiological findings of incidental Rathke's cleft cysts in children and adolescents. Ann Pediatr Endocrinol Metab. 19(1):20-6, 2014
                                                                          16. Kitajima M et al: Differentiation of common large sellar-suprasellar masses effect of artificial neural network on radiologists' diagnosis performance. Acad Radiol. 16(3):313-20, 2009
                                                                          17. Binning MJ et al: Hemorrhagic and nonhemorrhagic Rathke cleft cysts mimicking pituitary apoplexy. J Neurosurg. 108(1):3-8, 2008
                                                                          18. Glezer A et al: Rare sellar lesions. Endocrinol Metab Clin North Am. 37(1):195-211, x, 2008
                                                                          19. Rao VJ et al: Imaging characteristics of common suprasellar lesions with emphasis on MRI findings. Clin Radiol. 63(8):939-47, 2008
                                                                          20. Kunii N et al: Rathke's cleft cysts: differentiation from other cystic lesions in the pituitary fossa by use of single-shot fast spin-echo diffusion-weighted MR imaging. Acta Neurochir (Wien). 149(8):759-69; discussion 769, 2007
                                                                          21. Kim JE et al: Surgical treatment of symptomatic Rathke cleft cysts: clinical features and results with special attention to recurrence. J Neurosurg. 100(1):33-40, 2004
                                                                          22. Byun WM et al: MR imaging findings of Rathke's cleft cysts: significance of intracystic nodules. AJNR Am J Neuroradiol. 21(3):485-8, 2000
                                                                          23. Naylor MF et al: Rathke cleft cyst: CT, MR, and pathology of 23 cases. J Comput Assist Tomogr. 19(6):853-9, 1995