A Rare Case of Rathke Cleft Cyst Mimicking a Cavernous Carotid Aneurysm Hypopituitarism

Abstract

Rathke cleft cysts (RCC) are non-neoplastic masses typically located around the pituitary gland. In many patients, RCCs are asymptomatic and found incidentally via brain imaging or after death via autopsy. Incidental findings are becoming more common with the increase in imaging, however, some RCCs cause symptoms consisting of headaches, visual disturbances, or pituitary dysfunction. Asymptomatic lesions may be followed with serial imaging, but symptomatic lesions are often removed surgically. Due to varying appearance of RCCs on imaging, it can be difficult to differentiate RCCs from other pathology, such as adenomas, until surgery is performed. General imaging characteristics exist that may be more suggestive of RCCs compared to other pathology. Here, we present a rare case of a patient with a large RCC resulting in hypopituitarism.  Initial imaging suggested the possibility of a thrombosed cavernous aneurysm which was later ruled out.