Symptomatic Rathke's cleft cyst with amyloid stroma

SYNOPSIS A patient with panhypopituitarism and visual field defects due to a Rathke's cleft cyst is presented. These cysts are commonly found in random pituitaries examined at necropsy, but rarely produce symptoms. Subtle endocrine deficiencies, however, may now be uncovered more frequently with modern diagnostic techniques. An unusual and unreported feature of this cyst was an apudamy-loid stroma. This would imply that cells derived from the neural crest participate in the formation of the cyst. Recognition of these cysts at the time of operation is important in avoiding confusion with pituitary adenomas and unnecessarily aggressive treatment. Small cysts of Rathke's cleft which are asympto-matic are common (Bayouini, 1948; Shanklin, 1951). Occasionally, however, they may produce both neurological and endocrinological symp