Rathke cleft cyst with size fluctuation: A systematic literature review and case illustration

Dikran Richard Guisso, Ahmad Kareem Almekkawi, Tarek Y. El Ahmadieh, Julia Yi, Zachary Johnson, Jun Kim, Abdul Karim Ghaith, Salah G. Aoun, Elena V. Daoud, Jack M. Raisanen, Toral Patel, Bruce E. Mickey

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Background: Rathke cleft cysts (RCCs) are known sellar/suprasellar lesions that can grow and become symptomatic. For most asymptomatic lesions, stability is a typical outcome of surveillance; however, random relapse or cyst size fluctuation may also be observed. The conventional treatment for growing cysts is transsphenoidal removal. Methods: A literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. For significance, all journals were screened. Only records of tissue diagnosed RCCs with changes in size were included. Age and sex at diagnosis, size of the lesion, symptoms (if any), pituitary dysfunction, follow-up period, and size reduction were included in the data items. Results: A total of 4 articles where selected after the second exclusion method. Three articles where case series and one was a case report. Eight total patients where histologically proven to have Rathke cleft cysts which fluctuated in size without intervention. Conclusion: This review shows that RCCs can decrease or fluctuate in size following a dynamic process that is not fully understood. In the absence of symptoms, a larger cyst or an absolute increase in a cyst size, which may traditionally provoke an early surgical intervention, should be assessed and managed carefully to avoid potentially unneeded surgical morbidity.

Original languageEnglish (US)
Article number101198
JournalInterdisciplinary Neurosurgery: Advanced Techniques and Case Management
StatePublished - Sep 2021


  • Fluctuation
  • Observation
  • Rathke cleft cyst
  • Size change
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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