1996 Volume 5 Issue 1 Pages 37-42
A Rathke's cleft cyst that is entirely in the suprasellar region is rare, and only 17 Such cases have been reported in the literature. Herein we report one such case, that of a 58-year-old woman who was admitted to hospital because of a visual disturbance. Hospital tests revealed that her visual acuity was under 0.1 on both sides and a visual field examination uncovered left temporal hemianopsia. Further, CT scans showed a mass of low density in the suprasellar region, and MRIs revealed a mass of high intensity in the suprasellar region that extended to left cerebral peduncle. Although a radical or a partial excision, followed by radiation therapy, is widely recomended for craniopharyn-giomas, simple aspiration of the cystic fluid is advocated for a Rathke's cleft cyst. However, we could not preoperatively distinguish whether this mass was a Rathke's clef cyst or a cystic craniopharyngioma. Therefore, at time of surgery, an interhemispheric, trans-lamina terminalis approach was used for the purpose of performing a total resection. However, we did not perform a total resection of the capsule because tense adhesion of the cyst to the hypothlamus indicated that it was a Rathke's cleft cyst and aspiration was performed. The postoperative course was uneventful and the patient's visual acuity and visual field deficits improved.
