Rathke’s Cleft Cyst

This is a congenital, non-neoplastic, primarily suprasellar lesion that is derived from remnants of Rathke’s pouch. Rathke’s pouch is an embryological derivative of the oropharynx that develops into the anterior pituitary gland, or adenohypophysis. These masses are found in approximately 15% of autopsies, with a 2:1 female predilection. They most commonly present in adulthood after significant enlargement has occurred. Symptoms include visual disturbance from optic chiasm compression, pituitary dysfunction, and headaches. In contrast to craniopharyngiomas, Rathke’s cleft cysts arise from the pars intermedia of the pituitary, have a cell lining composed of single layer cuboidal epithelium, and the cyst contents resemble motor oil. Surgical treatment is recommended, with the procedure entailing partial excision and drainage - unlike craniopharyngiomas. There is an 18% recurrence rate following surgery.