Rathke's cleft cysts in children: clinical, diagnostic, and surgical features

Abstract

Rathke cleft cysts (RCCs) are malformative, benign lesions located in the sellar and/or suprasellar space; they are thought to arise from remnants of the Rathke pouch, where embryonic cells which are going to form the adenohypophysis join the nervous component that will become the neurohypophysis. These remnants may enlarge causing pituitary dysfunction and visual impairment. Cyst content may be a mucinous material of varying texture; the wall of the cyst is characterized by a well-differentiated, ciliated columnar epithelium. Magnetic resonance imaging (MRI) has increased sensitivity in RCCs radiologic diagnosis, even if symptoms related to the cyst are absent, so incidental findings are not unusual; in such cases, surgical therapy is questionable or not indicated. The prevalence of Rathke cleft cysts in children is considered lower than in adult population, in spite of their malformative nature, and young patients are mostly asymptomatic. We report a little series of symptomatic RCCs observed in children during an interval time of 4 years (2005–2008).