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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:1098-1100, May 2006
© 2006 American Society of Neuroradiology

Case Report
HEAD AND NECK

Intrasphenoidal Rathke Cleft Cyst

H. Megdiche-Bazarbacha^a, K. Ben Hammouda^b, A.B. Aicha^a, R. Sebai^a, L. Belghith^a, M. Khaldi^b and S. Touibi^a

^a Neuroradiology Service, National Neurology Institute, Tunis, Tunisia
^b Neurosurgery Service, National Neurology Institute, Tunis, Tunisia

Address correspondence to H. Megdiche-Bazarbacha, Neuroradiology Service, National Neurology Institute, Tunis, Tunisia

SUMMARY: Symptomatic Rathke cleft cysts (RCC) are reported in the sellar and suprasellar regions, but no case of sphenoidal RCC has been reported. We report a case of sphenoidal RCC in a 41-year-old man. The lesion was revealed by headaches and diplopia. Symptoms disappeared transiently after a spontaneous rhinorrhea but relapsed 4 months later. MR imaging showed a cystic sphenoidal lesion, isointense on T1-weighted images (WI) with peripheral gadolinium enhancement and hyperintense on T2 WI. The patient underwent surgery through a transrhinoseptal approach. The wall of the sphenoid sinus was paper-thin. The cyst contained a motor-oil-like fluid and communicated widely with the nasal fossa. Its wall was partially extracted. Symptoms and signs ceased after surgery. MR imaging performed 1 year later showed the disappearance of the sphenoidal cyst. Embryological origin of RCCs is discussed. The hypothesis of a continuum between the different epithelial cystic lesions of the sellar and parasellar region is discussed. Imaging has an important impact on the diagnosis; nevertheless, the specific characterization remains difficult.

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				F. Bonneville, J. Chiras, F. Cattin, and J.-F. Bonneville T2 Hypointense Signal of Rathke Cleft Cyst AJNR Am. J. Neuroradiol., March 1, 2007; 28(3): 397 - 397. [Full Text] [PDF]