Pituitary Infarction Associated with Rathke’s Cleft Cyst

Symptomatic patients with Rathke’s cleft cysts (RCCs) usually manifest headache, visual disturbance, or pituitary endocrine dysfunction. However, in rare instances, RCCs may present with acute onset mimicking pituitary tumor apoplexy, and the clinical and radiological characteristics in such cases remain uncertain. The occurrence of pituitary infarction associated with RCC has not been described. The author reports an interesting case of intra- and suprasellar RCC, with presenting features of pituitary apoplexy. This 51-year-old man suffered acute headache, vomiting, and partial hypopituitarism. The radiographic features on computed tomography and magnetic resonance imaging seemed most compatible with a suprasellar hemorrhagic tumor. Emergent drainage of the cyst contents through transsphenoidal surgery confirmed the diagnosis of RCC and necrotic pituitary tissue. The concept of RCC apoplexy will be introduced in this short communication, with its clinical manifestations, imaging features, histopathological features, and therapeutic outcomes.