Rathke Cleft Cyst

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A Rathke cleft cyst is a noncancerous fluid-filled mass that forms in a small space at the base of the brain. During fetal development of the pituitary gland, cells that form the anterior gland migrate up from the roof of the mouth and cells from the posterior gland migrate down from the brain. They meet and fuse together at the base of the brain in a spot known as the Rathke pouch. Most times, the pouch closes early in gestation, but sometimes it doesn’t and a small space, or cleft, remains. This cleft can eventually fill with fluid, forming what is called a Rathke cleft cyst.

Rathke cleft cysts are rare, accounting for less than one percent of all primary masses in the brain. They are typically very small — less than 2 mm — and usually cause no symptoms. In fact, most Rathke cleft cysts are discovered incidentally: when, for example, a magnetic resonance imaging (MRI) scan is used to diagnose another problem, commonly after a car accident or when a patient reports headaches with no known cause.

The masses are usually identified in adults, rarely causing problems during childhood, and more women than men are likely to develop them. Rathke cleft cysts are congenital deformities, meaning they develop during the prenatal stage and are present at birth. There are no known causes.

Symptoms may occur when a Rathke cleft cyst, which sits in a tiny space at the base of the brain, accumulates enough fluid to place pressure on surrounding structures. Unlike tumors, which grow through cell division, Rathke cleft cysts grow by accumulating fluid.

  • Compression of the optic nerves can cause many kinds of vision problems.
  • Increased pressure on the pituitary gland can cause pituitary failure, or hypopituitarism. The pituitary gland, part of the endocrine system, is often called the master gland because the hormones it releases help regulate other glands of the endocrine system.
  • If not treated, resulting hypothyroidism (abnormally low thyroid levels) and adrenal insufficiency (abnormally low cortisol levels) can be life-threatening.

About the Endocrine System
The endocrine system is the collection of glands that control metabolism, growth, and physical development; the immune system; sexual function; sleep; and mood; among other functions. The glands regulate these processes by releasing hormones into the bloodstream, which allows them to reach cells and organs anywhere in the body. The pituitary gland in particular secretes hormones that control the immune system and growth and physical development, as well releasing prolactin, which stimulates the mammary glands to produce milk. The “master gland” also releases hormones that regulate other glands, such as the thyroid gland, adrenal glands, and testes and ovaries.

The hypothalamus, just above the pituitary gland, regulates hunger, thirst, and sleep, and can also signal the pituitary gland to secrete hormones or inhibit their production.

Reviewed by Georgiana Dobri, MD
Last reviewed/last updated: September 2017