Rathke’s cleft cysts (RCC) are non-cancerous, fluid-filled cysts that develop between the parts of the pituitary gland at the base of the brain. These rare tumors – which comprise less than one percent of all brain tumors – are believed to develop while a fetus is growing in the womb. They can affect the adjacent pituitary gland and optic nerve, so treatment may require coordination among specialists.
Most Rathke’s cleft cysts are small and rarely cause symptoms or problems during childhood. They are usually diagnosed in adulthood when symptoms occur due to compression of the surrounding pituitary gland and optic nerves. Symptoms can include:
Rathke’s cleft cysts are diagnosed by a patient’s symptoms, physical exam and specialized testing. Specialized testing may include:
Observation – Most small and non-symptomatic Rathke’s cleft cysts can be observed over time with surveillance MRI scans.
Surgical drainage – used when larger cysts cause significant symptoms. A neurosurgeon and ear, nose and throat surgeon who specialize in skull base surgery collaborate to drain the cyst through minimally invasive endoscopic skull base techniques using a three-dimensional model of the brain and skull base (stereotactic guidance). This procedure can usually be done without damaging the normal pituitary gland.