Rathke Cleft Cyst with T2 Hypointensity: MRI Features, Differential Diagnosis, and Evidence-Based Management
Introduction Rathke cleft cyst (RCC) is a benign, non-neoplastic epithelial cyst arising from remnants of Rathke’s pouch , located in the pars intermedia of the pituitary gland . While most RCCs are asymptomatic and incidentally discovered, certain imaging characteristics—particularly T1 hyperintensity combined with striking T2 hypointensity —represent a distinct and diagnostically important subtype. This article presents a classic case of Rathke cleft cyst with T2 hypointensity , based on the attached MRI study of a 25-year-old woman with oligomenorrhea and mild hyperprolactinemia. Using this case, we comprehensively review the pathophysiology, epidemiology, clinical presentation, imaging features, differential diagnosis, diagnostic approach, treatment strategies, and prognosis , grounded in widely cited contemporary literature. Pathophysiology of Rathke Cleft Cyst with T2 Hypointensity Rathke cleft cysts originate from embryologic remnants of Rathke’s pouch , whi...