Rathke's cleft cyst is an abnormal fluid-filled (cyst) sac that usually is found between the anterior and posterior pituitary glands.
The UCLA Pituitary Tumor Program offers comprehensive management of Rathke's cleft cyst. Our physicians have years of experience in diagnosing, treating and managing pituitary conditions. We use the most sophisticated diagnostic equipment and offer minimally invasive surgical procedures.
Use the links to explore more about Rathke's cleft cyst:
What we refer to as the "pituitary gland" is actually made up of two glands: the anterior (adenohypophysis) and posterior (neurohypophysis) glands. As a fetus develops:
The place where the anterior and posterior glands meet is called Rathke's pouch. This pouch normally closes early in fetal development, but a remnant often persists as a cleft. Occasionally, this remnant gives rise to a large cyst called the Rathke's cleft cyst (RCC).
Rathke's cleft cysts that cause symptoms are relatively uncommon lesions, accounting for less than one percent of all primary masses within the brain. They can occur at any age, although most are identified in adults. Rathke's cleft cysts sometimes occur together with pituitary adenomas.
Often, Rathke's cleft cysts do not cause symptoms. Many times, doctors find the cyst while a patient is undergoing a magnetic resonance imaging scan (MRI) for a different reason. If the tumor grows to a large size, it may cause symptoms because it is compressing surrounding structures.
Larger Rathke's cleft cysts may cause:
Increased compression of the normal gland can cause hormone insufficiency, called hypopituitarism. The symptoms depend upon which hormone is involved.
More severe hypopituitarism can lead to hypothyroidism or abnormally low cortisol levels, which may be life threatening. Symptoms of severe hypopituitarism include:
You may also experience headaches.
Your doctor will conduct a physical exam and ask you about your symptoms and medical history. Other diagnostic procedures include:
One method we use to detect Rathke's cleft cysts is a magnetic resonance imaging (MRI) of the pituitary gland. We use a special MRI pituitary protocol in order to best visualize the tumor.
Occasionally, your doctor may order a computed tomography (CT) scans of the brain, though it is less reliable than an MRI scan.
In order to confirm a diagnosis of Rathke's cleft cyst, your doctor will need to rule out other possible conditions that present with a pituitary cyst:
If your symptoms suggest pituitary failure (hypopituitarism), your doctor will order a complete evaluation of the endocrine system. Based on results of these blood tests, you may need additional hormonal studies. Learn more about hormone testing at the UCLA Pituitary Tumor Program.
If you are experiencing vision problems, you should visit an ophthalmologist and undergo a thorough evaluation, including:
If you are experiencing symptoms, you will require surgery.
Surgery for Rathke's cleft cysts includes draining the fluid from the cyst.
Most neurosurgeons specializing in Rathke's cleft cyst surgery use the minimally invasive endoscopic technique. In experienced hands, the endoscopic approach minimizes complications, hospitalization time and discomfort
This advanced technique requires specialized training and equipment and should be performed at a dedicated pituitary tumor center.
The recurrence rate following surgical treatment is about 20 percent. You will need to undergo yearly MRI surveillance to check if the cyst has recurred.
To schedule an appointment with one of our physicians at the Pituitary Tumor Program, please call (310) 825 5111.