Intrasphenoidal Rathke’s cleft cyst

• Rathke’s cleft cysts (RCC) are benign, epithelial lined cystic remnants of the craniopharyngeal duct.
• Typical locations for RCC are either entirely intrasellar or intrasellar with suprasellar extension.
• A rare case of an intrasphenoidal RCC is reported.
• Being aware of this location of RCC may allow consideration of this diagnosis preoperatively facilitating preoperative counseling and limiting the extent of the surgical approach and resection.

We report a rare patient with an intrasphenoidal Rathke’s cleft cyst (RCC) and review the literature. RCC are benign epithelium lined cysts containing mucoid material, which typically occur in a location that is either entirely intrasellar, or intrasellar with suprasellar extension (intra-suprasellar). RCC in a completely extrasellar location are uncommon. An intrasphenoidal RCC is extremely rare with only two patients reported in the literature to date. Preoperative diagnosis is difficult due to the uncommon location and absence of any characteristic radiological features. However, it remains of utmost clinical relevance because it may limit the operative management to biopsy sampling of the cyst wall and drainage of the contents via the transsphenoidal route.