title: Ruptured Rathke cleft cyst mimicking pituitary apoplexy.
abstract: Rathke cleft cysts (RCCs) are benign cystic lesions of the sellar and suprasellar region that are asymptomatic in most cases. Occasionally, compression of the optic pathway and hypothalamo-pituitary structures may cause clinical symptoms, such as headaches, visual deficits and endocrinopathies. Acute presentation caused by hemorrhage into an RCC have been described in the literature, and the term "Rathke cleft cyst apoplexy" has been coined. We present the case of a 32-year-old man with acute onset of meningitis-type symptoms and imaging findings resembling hemorrhagic pituitary tumor apoplexy. In retrospect, clinical symptoms, intraoperative appearance, and histologic examination were compatible with the diagnosis of nonhemorrhagic rupture of an RCC. Thus, the clinical presentation of "Rathke cleft cyst apoplexy" is not necessarily caused by hemorrhage.
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Marian Christoph
authors.initials: MC
authors.lastname: Neidert
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Christoph Michael
authors.initials: CM
authors.lastname: Woernle
authors.affiliation: Department of Neuropathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Henning
authors.initials: H
authors.lastname: Leske
authors.affiliation: Division of Endocrinology and Diabetes, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Diane
authors.initials: D
authors.lastname: Möller-Goede
authors.affiliation: Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Athina
authors.initials: A
authors.lastname: Pangalu
authors.affiliation: Division of Endocrinology and Diabetes, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmid
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: René-Ludwig
authors.initials: RL
authors.lastname: Bernays
mesh_terms: D000328:Adult; D020863:Central Nervous System Cysts / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D005334:Fever / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures; D010899:Pituitary Apoplexy / Q000175:diagnosis*; D012421:Rupture