Hemorrhagic sellar lesion mimicking pituitary adenoma apoplexy: MRI follow-up suggesting Rathke cleft cyst.
| Τίτλος: | Hemorrhagic sellar lesion mimicking pituitary adenoma apoplexy: MRI follow-up suggesting Rathke cleft cyst. |
|---|---|
| Συγγραφείς: | Dier C; Florida International University Herbert Wertheim College of Medicine, 11200 SW 8th St, Miami, FL, 33199, USA., Sidani C; Florida International University Herbert Wertheim College of Medicine, 11200 SW 8th St, Miami, FL, 33199, USA.; Baptist Health of South Florida/Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL, 33176, USA., Abrams KJ; Florida International University Herbert Wertheim College of Medicine, 11200 SW 8th St, Miami, FL, 33199, USA.; Baptist Health of South Florida/Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL, 33176, USA., Freitas LF; Florida International University Herbert Wertheim College of Medicine, 11200 SW 8th St, Miami, FL, 33199, USA. drleonardofurtado@gmail.com.; Baptist Health of South Florida/Radiology Associates of South Florida, 8900 N Kendall Dr, Miami, FL, 33176, USA. drleonardofurtado@gmail.com. |
| Πηγή: | Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2026 Oct 03; Vol. 47 (10). Date of Electronic Publication: 2026 Oct 03. |
| Τύπος έκδοσης: | Case Reports; Letter |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Springer-Verlag Italia Country of Publication: Italy NLM ID: 100959175 Publication Model: Electronic Cited Medium: Internet ISSN: 1590-3478 (Electronic) Linking ISSN: 15901874 NLM ISO Abbreviation: Neurol Sci Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Milano, Italy : Springer-Verlag Italia, c2000- |
| Ιατρικοί όροι (MeSH): | Central Nervous System Cysts*/diagnostic imaging , Central Nervous System Cysts*/complications , Pituitary Apoplexy*/diagnostic imaging , Pituitary Apoplexy*/diagnosis , Pituitary Neoplasms*/diagnostic imaging , Pituitary Neoplasms*/diagnosis , Adenoma*/diagnostic imaging , Adenoma*/diagnosis , Sella Turcica*/diagnostic imaging , Sella Turcica*/pathology, Humans ; Female ; Magnetic Resonance Imaging ; Young Adult ; Diagnosis, Differential ; Follow-Up Studies |
| Περίληψη: | Rathke cleft cysts (RCCs) are benign epithelial sellar and suprasellar lesions arising from remnants of Rathke pouch. Although typically incidental and asymptomatic, intracystic hemorrhage is rare and may mimic pituitary adenoma apoplexy. We report a 19-year-old woman presenting with one week of progressive severe headache. CT demonstrated sellar enlargement with suprasellar extension. MRI showed a hemorrhagic sellar lesion centered in the pars intermedia/posterior pituitary with fluid-fluid levels, dependent T2 hypointense components, susceptibility-related signal loss, and suprasellar extension abutting the optic chiasm, without nodular enhancement. Neurologic, ophthalmologic, and endocrinologic evaluations were unremarkable. Conservative management with corticosteroids and observation was pursued. Follow-up MRI at 3 months demonstrated markedly decreased pituitary enlargement with evolution into a small residual nonenhancing pars intermedia cyst, suggesting a hemorrhagic RCC. Recognition of this rare entity may support conservative management and avoid surgery in clinically stable patients. (© 2026. Fondazione Società Italiana di Neurologia.) |
| Competing Interests: | Declarations. Ethical approval: Ethical approval was waived by the local Ethics Committee due to the retrospective nature of this case report, and all procedures performed were part of routine clinical care. Conflict of interest: The authors declare no competing interests or conflicts of interest related to this work. Consent to participate: Written informed consent was obtained from the patient. Patient information was anonymized. Consent to publish: Written informed consent for publication of the case details and accompanying images was obtained from the patient. Prior presentation: This work has not been previously presented, in whole or in part, at any scientific meeting. Guarantor: Dr. Leonardo Furtado Freitas accepts full responsibility for the integrity of the data, the accuracy of the analysis, and the decision to publish. Originality: This manuscript is original, has not been previously published, and is not under consideration for publication elsewhere. |
| References: | AJNR Am J Neuroradiol. 2015 Oct;36(10):1866-73. (PMID: 26251436) J Clin Endocrinol Metab. 2022 May 17;107(6):1751-1758. (PMID: 35092687) J Clin Endocrinol Metab. 2024 Jan 18;109(2):e711-e725. (PMID: 37698130) Acta Neurochir (Wien). 2007 Aug;149(8):759-69; discussion 769. (PMID: 17594050) J Neurosurg. 2008 Jan;108(1):3-8. (PMID: 18173304) Eur J Radiol. 2025 Dec;193:112429. (PMID: 40975911) AJNR Am J Neuroradiol. 2000 Mar;21(3):485-8. (PMID: 10730639) Clin Endocrinol (Oxf). 2014 Mar;80(3):419-24. (PMID: 23909507) Clin Endocrinol (Oxf). 2011 Jan;74(1):9-20. (PMID: 21044119) J Neurosurg. 2011 Feb;114(2):318-24. (PMID: 20509729) J Neurosurg. 2021 Apr 30;135(5):1310-1318. (PMID: 33930863) World Neurosurg. 2020 Oct;142:e1-e9. (PMID: 32217176) |
| Contributed Indexing: | Keywords: Hemorrhagic sellar lesion; Magnetic resonance imaging; Pituitary apoplexy; Rathke cleft cyst |
| Entry Date(s): | Date Created: 20261002 Date Completed: 20261002 Latest Revision: 20261008 |
| Update Code: | 20261008 |
| DOI: | 10.1007/s10072-026-09460-z |
| PMID: | 42827207 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1590-3478 |
|---|---|
| DOI: | 10.1007/s10072-026-09460-z |