Rathke Cleft Cysts
What are Rathke cleft cysts?
Rathke cleft cysts (RCCs) are benign (non-cancerous) fluid-filled growths that develop between the parts of the pituitary gland at the base of the brain. They are congenital deformities, meaning that they develop while a fetus is growing in the womb. An RCC develops from a piece of the fetus’ developing Rathke pouch, which ultimately becomes part of the pituitary gland.
Rathke cleft cysts are rare. And, they rarely cause symptoms or problems during childhood, so they are not usually diagnosed in kids. Rather, they are most often found in adults during an MRI scan to diagnose another problem, or even after death, if an autopsy is done. Women are more likely to develop this condition compared to men.
If Rathke cleft cysts become large enough, they can cause vision changes or various problems with the pituitary gland's normal processes.
What causes Rathke cleft cysts?
Rathke cleft cysts are thought to occur very early in the fetal development when the inside of the Rathke pouch does not go away as it normally does. This leaves a space that can fill with fluid and grow over time. There are no known outside causes of RCCs.
What are the symptoms of Rathke cleft cysts?
Rathke cleft cysts grow in a small space at the base of the brain. They can press on the nerves leading from the eyes to the brain, which can cause vision changes. The most common symptoms include:
- Vision changes
- Frequent headaches
- Feelings of drowsiness or fatigue
- Changes in personality or behavior, including confusion
Cysts can also press on the pituitary gland, which can affect the levels hormones secreted by this gland. This can cause symptoms at different stages of life:
- Lack of growth or late puberty in children
- Irregular or absent menstruation
- Production and leaking of milk from the breasts that is not related to pregnancy or childbirth
- Low blood pressure
- Digestive issues, such as constipation
- Low or no libido
- Feelings of extreme thirst
- Unusually dry skin
- Difficulty regulating body temperature
How are Rathke cleft cysts diagnosed?
Rathke cleft cysts are typically diagnosed with an MRI or CT imaging of the brain. Rathke cleft cysts are sometimes first misdiagnosed as pituitary gland tumors.
Blood tests to check hormone levels and exams to check vision might also be done.
How are Rathke cleft cysts treated?
The treatment of Rathke cleft cysts depends on the symptoms. Small RCCs that do not cause any symptoms do not require treatment. Larger RCCs that are causing symptoms may require surgery, which could include draining and removal of the cyst.
What are the complications of Rathke cleft cysts?
Without treatment, Rathke cleft cysts can continue to cause problems with pituitary gland function and issues with weight, hormones, and vision. Proper diagnosis and treatment can relieve symptoms and restore healthy pituitary function.
Key points about Rathke cleft cysts
- Although they are not cancerous, Rathke cleft cysts can be mistaken for tumors.
- They require treatment (usually surgery) if they interfere with vision or with the normal functioning of the pituitary gland.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
April 08, 2017
Trifanescu, R., Rathke's cleft cysts, Clinical Endocrinology (2012); 76; 151-160
Dozier, Tennille, RN, BSN, RDMS,Shelat, Amit, MD