Rathke's Cleft Cysts

Rathke cleft cysts are benign lesions that form from remnants of the embryologic Rathke pouch and are frequently identified in nearly one in six autopsies or healthy volunteers undergoing MRI. Athough usually asymptomatic, Rathke cleft cysts, particularly those whose contents are inflammatory, can cause symptoms like headaches, endocrine dysfunction, and, rarely, visual disturbances. Symptomatic Rathke cleft cysts warrant surgical resection, usually through a transsphenoidalendonasal corridor using either a microscope or an endoscope. While surgery is associated with minimal morbidity, the natural history of asymptomatic Rathke cleft cysts is one of slow growth, suggesting that observation through serial MRI is appropriate for smaller asymptomatic Rathke cleft cysts. For symptomatic Rathke cleft cysts, surgery provides good symptomatic relief of headaches and visual disturbance, and can even sometimes improve endocrine dysfunction.