Clivus Rathke cleft cyst: case report of a rare disease and literature review

Abstract

Background: Rathke's cleft cysts (RCCs) are nonneoplastic epithelial lesions derived from true remnants of the embryological Rathke's pouch. They are commonly located in the sellar and suprasellar region and usually appear as an asymptomatic mass. Case: A 56-year-old male with a clivus centered isodense mass shown on a CT scan, no bone erosions on the lateral or posterior walls of the clivus, and no compromise of the sella turcica floor. Based on the radiological findings, the most likely diagnosis proposed were chordoma, mucocele, metastatic tumor, Rathke's cyst, Tornwald's cyst or ectopic craniopharyngioma. An endoscopic endonasal trans-sphenoidal approach was done for resection of the lesion. The histopathologic exam revealed a Rathke's cyst. The patient has had an uncomplicated course and remains symptom-free after 12 months follow up. Conclusion: Rathke's cleft cysts (RCCs) are rare exclusive clival lesions , which should be taken into account in the differential diagnosis of clival lesions. It can be surgically treated by an endoscopic conservative way.

Keywords

• sinonasal tumors
• clivus
• endoscopic skull base surgery
• endonasal approaches
• endoscopic sinus surgery
• rathke's cleft cyst