Chemical meningitis: A rare presentation of Rathke’s cleft cyst

Abstract Rathke’s cleft cysts (RCC) are usually benign, sellar and/or suprasellar lesions originating from the remnants of Rathke’s pouch. Rarely, RCC can present with chemical meningitis, sellar abscess, lymphocytic hypophysitis, or intracystic hemorrhage. We describe an unusual presentation of RCC in which the patient presented with a clinical picture of chemical meningitis consisting of meningeal irritation, inflammatory cerebrospinal fluid profile, and enhancing pituitary and hypothalamic lesions, in addition to involvement of the optic tracts and optic nerve.