Diagnosis and treatment of Rathke's cleft cyst in sellar region

Objective To explore the diagnosis and treatment strategies of Rathke's cleft cysts (RCC) in the sellar region through analyzing their imaging characteristics.Methods Thirty-two patients with RCC in the sellar region,including two also with concomitant pituitary adenoma,admitted to and performed surgery in our hospital from January 2005 to August 2011,were chosen in our study.The clinical features,especially MRI and histological appearances,were retrospectively reviewed.The experiences on their diagnosis and treatment were summarized.Results Preoperatively,only 3 patients were diagnosed or suspected as RCC.MR images revealed 10 intracystic nodules in 9 patients; their MR signal intensity was variable; not all nodules on T2-weighted images were visualized.Two nodules had bull' s eyelike changes.The hyper-intense content on T1-weighted images was not definitely associated with serious symptoms.Postoperative MRI revealed recurrence or residual lesion in 5 of 26 patients.Conclusion Intracystic nodules with homogenous intensity and non-enhancement under MRI are unique for sellar RCC; Bull's eyelike changes in the intracystic nodule under MRI might have value for confirming the diagnosis.Pituitary inflammation should not be neglected when the clinical symptoms and MRI findings of RCC are being explained. Key words: Rathke' s cleft cyst;  Diagnosis;  Intracystic nodule;  Microsurgery