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CC BY-NC-ND 4.0 · Asian J Neurosurg 2022; 17(03): 527-531
DOI: 10.1055/s-0042-1750798
Case Report

Rathke's Cleft Cyst Abscess with a Very Unusual Course

Amy Coulden
1   Department of Endocrinology, Queen Elizabeth Hospital, Birmingham, United Kingdom
2   Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
3   Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
,
Joshua Pepper
4   Department of Neurosurgery, Queen Elizabeth Hospital, Birmingham, United Kingdom
,
Agata Juszczak
5   Department of Endocrinology, Birmingham Heartlands Hospital, Birmingham, United Kingdom
,
Ruchika Batra
6   Department of Ophthalmology, Queen Elizabeth Hospital, Birmingham, United Kingdom
,
Swarupsinh Chavda
7   Department of Radiology, Queen Elizabeth Hospital, Birmingham, United Kingdom
,
Latha Senthil
7   Department of Radiology, Queen Elizabeth Hospital, Birmingham, United Kingdom
,
John Ayuk
1   Department of Endocrinology, Queen Elizabeth Hospital, Birmingham, United Kingdom
3   Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
,
Ute Pohl
8   Department of Cellular Pathology, Queen Elizabeth Hospital, Birmingham, United Kingdom
,
Santhosh Nagaraju
8   Department of Cellular Pathology, Queen Elizabeth Hospital, Birmingham, United Kingdom
,
Niki Karavitaki
1   Department of Endocrinology, Queen Elizabeth Hospital, Birmingham, United Kingdom
2   Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
3   Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
,
Georgios Tsermoulas
2   Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
4   Department of Neurosurgery, Queen Elizabeth Hospital, Birmingham, United Kingdom
› Author Affiliations Funding None.
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Abstract

Infected Rathke's cleft cysts (RCC) are extremely rare with only a few published cases. We report the case of a 31-year-old man who presented with headaches, visual disturbance, and hypopituitarism secondary to an infected RCC with extension of abscesses along the optic tract. Magnetic resonance imaging showed ring enhancing cystic lesions within an expanded sella with suprasellar and intraparenchymal extension. The radiological appearance suggested a high-grade optic glioma, but an endoscopic transsphenoidal biopsy revealed frank pus in the pituitary fossa, which subsequently grew Staphylococcus aureus. Pathological examination of the cyst wall showed an inflamed RCC. Following a prolonged course of intravenous antibiotics, the infection resolved and vision improved. RCC abscesses are rare and the intracranial extension of the infection in our case makes it unique.

Keywords

Rathke's cleft cyst - pituitary abscess - transphenoidal surgery


Publication History

Article published online:
01 September 2022

© 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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