Abstract
This paper reports a case of a transcranial surgery in a patient with a symptomatic Rathke’s cleft cyst. The patient was a 54-year-old woman visited us with a chief complaint about chronic retrobulbar pain. Goldmann visual field tests revealed visual field defects in the bitemporal upper quadrant part and enlargement of the bilateral blind spot of Mariotte. MRI demonstrated a cystic lesion in the intra suprasellar region. The cyst was located on the pipuitary gland. The content of the cyst displayed hyperintensity on T1WI and hypointensity on T2WI, respectively. The diaphragma sellae was elevated and extended by the cyst. Considering a locational relationship between the cyst and the pituitary gland, and high viscosity of the cyst content, we decided to perform a transcranial surgery for an adequate resection of the cyst wall and evacuation of the content. The patient underwent a right fronto-temporal craniotomy with extradural anterior clinoidectomy. The cyst content was evacuated and the cyst wall was resected. The content was very viscid and waxy. Pathologic examination revealed that the cyst wall consisted of single or multiple ciliated columnar cells. Inflammatory cellular infiltration was also observed in the cyst wall. Retrobulbar pain subsided just after the operation and visual field disturbance also disappeared.
