Sunday 25 December 2016

Rathke’s Cleft Cyst


High T1 & T2 slightly expansile sellar lesion, displaces normal pituitary tissue.

Non-neoplastic remnants of Rathke’s pouch

Majority are asymptomatic, symptoms include visual defects, pit insufficiency, headaches.

Can be high or low T1 but always high T2.

Arachnoid cyst
Pituitray adenoma

Rathke’s Cleft Cyst
Nonneoplastic cyst arising from remnants of embryonic Rathke cleft.

Best diagnostic clue is nonenhancing, noncalcified intra/suprasellar cyst with intracystic nodule
Uncommon but pathognomonic = "posterior ledge sign", upward extension through diaphragma sellae with ledge of tissue overlying posterior lobe

40% completely intrasellari 60% suprasellar extension
Most RCCs are limited to sella, between anterior, intermediate lobes.
Most symptomatic RCCs are between 5-15 mm in diameter.

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