Journal
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volume 107, Issue 6, Pages 1751-1758Publisher
ENDOCRINE SOC
DOI: 10.1210/clinem/dgac033
Keywords
sellar magnetic resonance imaging; pituitary adenoma; Rathke cleft cyst; craniopharyngioma; sellar arachnoid cyst
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Cystic lesions in the sellar region are diverse and challenging to diagnose due to their similar clinical presentations, but imaging features can aid in differential diagnosis.
Cystic lesions arising in the sellar region are not uncommon and encompass cystic pituitary adenomas, Rathke cleft cysts, craniopharyngiomas, and arachnoid cysts. Their clinical presentation may be similar, including headache, visual field defects, and anterior pituitary hormone deficits, which makes differential diagnosis challenging. On the other hand, imaging features may indicate certain pathologies. In this approach to the patient, we describe the case of a patient who presented with right temporal hemianopsia and a sellar/suprasellar cystic lesion, which was determined to be Rathke cleft cyst. We discuss the imaging characteristics that may suggest a particular diagnosis between Rathke cleft cyst, cystic pituitary adenoma, craniopharyngioma, and arachnoid cyst and propose a flowchart for aiding in the imaging differential diagnosis.
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