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A Case of Rathkes Cleft Pouch Infiltrated into the Clivus
Dept. of Neurological Surgery , Chiba Univ., College of Medicine
Toshimasa SHIN, Toshimasa SHIN, Kentaro HORIGUCHI, Hirokazu SUNAOKA, Norio ISHIWATARI, Naokatu SAEKI
A 63 years old woman consulted a doctor on september 2014 . She presented diplopia due to right abducens nerve palsy. Neuroimaging examinations revealed a cystic mass in the clivus and introducted to our hospital. Computed tomography revealed osteoclastic mass lesion in the clivus and invasive sphenoidal sinus. Magnetic resonance imaging revealed the lesion iso- to hyperintense on T(1)- weighted and hyperintense on T(2)-weighted imaging, with peripheral enhancement after gadolinium administration. She underwent endoscopic transsphenoidal surgery on december 2014. The mass lesion was invasive sphenoidal sinus over the mucous membrane as expected by preoperative examination . We submitted the mucosa and cyst wall to operative rapid pathologic diagnosis. Diagnosis was rathke¡¯s cleft cyst. The operation was finished after saline irrigation in the cyst. After the operation right abducens nerve palsy was improved. Preoperative differential diagnosis were sphenoid sinus mucocele, ectopic pituitary adenoma and chordoma but it wasn¡¯t seemed to be rathke¡¯s cleft cyst. Rare case of clivus rathke¡¯s cleft cyst has been reported, so we report this case.


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