Rathke's cleft cyst

Findings:
A round fluid signal mass is present in the sella, extending into the infundibular region. The postcontrast images show minimal enhancement around the rim of the mass.

Differential Diagnosis:
Rathke's cleft cyst, craniopharyngioma, cystic pituitary adenoma less likely

Discussion:
Craniopharyngioma and Rathke's cleft cyst both arise from squamous epithelial remnants of anterior lobe. Craniopharyngioma arises from the pars tuberalis and Rathke's arises from pars intermedia. Rathke's cleft cysts are 2/3 intrasellar and 1/3 suprasellar, contain fluid which is mucoid, serous, or has cellular debris, and have variable MR signal depending on composition. 50% may have minimal peripheral enhancement, but the degree of enhancement is usually on of the most helpful factors to distinguish this lesion from craniopharyngioma.
 
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