Rathke's Cleft Cyst
A Rathke's cleft cyst is a rare type of cyst believed to originate from remnants of the Rathke pouch. During embryonic development, the Rathke pouch forms as a depression in the roof of the mouth, eventually losing its connection to the pharynx and giving rise to the anterior pituitary gland.

If instead of regressing the cleft persists and enlarges, it may form into a Rathke's cleft cyst. Most of these cysts are:

Very small (less than 2 mm)
Cause no symptoms
Discovered incidentally from imaging studies for other conditions

In some instances, continual accumulation of fluid may cause the cyst to grow. As it grows it places pressure on surrounding structures, including:

Pituitary gland
Optic chiasm
Hypothalamus

This pressure results in associated symptoms of Rathke's cleft cysts.

Rathke's cleft cysts are very similar in presentation and origin to craniopharyngiomas. The difference is that craniopharyngiomas grow by cell division and fluid accumulation, whereas Rathke's cleft cysts grow only by fluid accumulation.

At UPMC, the preferred surgical treatment for Rathke's cleft cyst is the Endoscopic Endonasal Approach (EEA). This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors. Benefits of EEA include:

No incisions to heal
No disfigurement
Faster recovery time