Rathke's Cleft Cysts- Review of Two Cases

Introduction: A Rathke's cleft cysts are myoepithelial benign cystic formations located at the sellar region. Most often they are diagnosed incidentally and the most of them are asymptomatic. Good results are accomplished by surgical treatment with proper indications, adequate operative technics and clinic trial. Aim: To present 2 cases that has been treated in the Department of Neurosurgery Tokuda Hospital, Sofia and to compare the results with the literature. Materials and Methods: Case 1: Male, 56 years old. For a few months with progressive vision weakness, lost weight, permanent headache. Objective - obesity, reduced face strigose. Neuroophtalmologist: Endocrinologist: diabetes insipidus, obesity. MRI: Surgical treatment by transcranial resection. Postoperative- diabetes insipidus, significant improvement. Discharged without complaints. Case 2: Female, 24 year old. Permanent headache, irregular menstrual cycle. Neuroophthalmologist: Endocrinologist: MRI: Surgical transsphenoidal resection is done. Discharged without complaints. Discussion: Clinically prominent cases are rare - 2% of all transsphenoidal intra/subsellar lesions. The most frequent clinical symptoms are: impaired vision and perimetry, headache, diabetes insipidus, pan hypopituitarism, hypocortisolemia, hypogonadism. Surgical treatment: transsphenoidal endoscopy resection and microsurgical technics. Good postoperative results.25% of cysts recidivates and the cause is the impossibility of a total capsular resection and/or histological characteristics of cyst’s structure. Conclusion: The early diagnostics, treatment and postoperative monitoring are prime objectives for the proper treatment.