Rathke's cleft cysts mimicking pituitary apoplexy

Pituitary apoplexy is characterized by clinical symptoms such as sudden onset of headache, vomiting, loss of visual acuity, visual field defects, diplopia, decreased consciousness, and hypopituitarism, and it is attributed to haemorrhage and/or infarction of a pituitary adenoma. Rathke's cleft cyst, a sellar tumour that appears as a cystic mass lesion on MRIs, can in rare cases present in a similar manner to pituitary apoplexy, with haemorrhage, hypophysitis, chemical meningitis, and abscess formation. Because the symptoms and neuroimaging of Rathke's cleft cyst with acute onset mimic those of pituitary apoplexy, it is difficult to diagnose Rathke's cleft cyst with acute onset preoperatively. Since Rathke's cleft cyst is important in the differential diagnosis of pituitary apoplexy, the clinical, radiological, and pathological features of Rathke's cleft cyst with acute onset are described.