Clinical, Imaging And Pathological Features Of Infected Atypical Rathke's Cleft Cyst With Secondary Pituitary Abscess Formation

Infected atypical Rathke's cleft cyst (RCC) is a rare cause of secondary pituitary abscess. A thirty year old afebrile female presented with a two year history of diabetes insipidus with loss of vision in the left eye over a period of one month. Brain imaging showed a large heterogenous sellar and suprasellar mass with left parasellar extension. The lesion demonstrated a thick, partially calcified wall and a central cystic component with an intracystic nodule. Craniopharyngioma was considered as a likely possibility due to lack of awareness of the imaging features of atypical RCC. However, the typical pattern of calcification and the MR signal intensity of the intracystic nodules can provide valuable clues to differentiate this uncommon lesion from craniopharyngioma and can guide the further clinical and operative management.