Two collision sellar lesions: Rathke's cleft cyst with non-functional pituitary adenoma and Rathke's cleft cyst with plurihormonal adenoma

Abstract

Introduction: Collision lesions of the sella involving pituitary adenomas and Rathke's cleft cysts (RCC) are considered a rare entity. Pre-operative diagnosis is challenging due to the variable MRI findings associated with RCC and similar clinical presentations as pituitary adenomas. Case report: We report two collision lesions involving a non-functional pituitary adenoma with RCC and a plurihormonal adenoma producing prolactin and adrenocorticotrophic hormone with RCC. Both lesions were diagnosed with histopathological analysis and successfully treated with endoscopically-guided transnasal- transphenoidal surgery. Conclusion: The diagnosis of pituitary ademonas with coexisting RCC should be considered when a cyst is visualized within, or adjacent to, pituitary adenomas detected by MRI, or when cystic contents with varying viscosities and color are discovered intraoperatively.