Introduction and importance: Rathke's cleft cyst (RCC) are non-malignant lesions arising from remnants of Rathke's pouch in the pituitary gland. Apoplexy is seen commonly in pituitary macroadenomas but very rarely in RCCs.
Case presentation: A 30-year-old male presented with a severe headache and vomiting. Imaging revealed an enlarged pituitary gland with possible hemorrhage in a RCC. The cyst was evacuated with endonasal transsphenoidal surgery, and histology confirmed RCC. Follow-up imaging showed complete cyst resolution, although he required levothyroxine for hypothyroidism.
Clinical discussion: The occurrence of hemorrhage within RCCs, although rare, mimics pituitary tumor apoplexy often complicating the diagnosis. The management is similar to pituitary tumor apoplexy, primarily involving surgical intervention. Postoperative care may require long-term hormonal replacement therapy in a significant number of patients.
Conclusion: This report underscores the importance of considering RCC in the differential diagnoses of pituitary lesions with hemorrhage with promising surgical outcome.
Keywords: Case report; Pituitary apoplexy; Rathke cleft cyst; Transsphenoidal surgery.
Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.