To analyze the clinical features and treatment of pituitary adenoma complicated with Rathke cyst.

The clinical data of 27 patients with pituitary adenoma complicated with Rathke cyst who underwent transsphenoidal sinus resection were retrospectively analyzed in the Second Ward of Neurosurgery Department of the First Affiliated Hospital of Harbin Medical University from January 2010 to December 2018. All patients underwent MRI examination and endocrine examination before and after surgery. Extracted specimens are pathologically diagnosed by an experienced pathologist to ensure accurate classification of functional pituitary adenomas. The changes of patients’ condition after operation were observed and the endocrine results on the first and seventh day were recorded. The clinical data of 27 cases of pituitary adenoma complicated with Rathke cyst were analyzed in combination with relevant literature.

The clinical symptoms of pituitary adenoma with Rathke cyst were similar to those of pituitary adenoma. MRI showed two different signals (solid lesion on one side and cystic lesion on the other side) in the pituitary region, with or without significant interval between the two signals, and enhanced solid lesions but not cystic lesions were observed. Total resection was performed in 27 patients, and solid tumor and semicfluid Rathke cyst contents were observed intraoperatively. During the follow-up, one pituitary adenoma with prolactin type recurred with increased prolactin, while the other patients did not relapse and their hormone levels returned to normal.

Pituitary adenoma with Rathke cyst is rare and the symptoms are similar to pituitary adenoma. The diagnosis depends on pathology. MRI pituitary cystic and solid lesions coexist, pituitary tumors with Rathke cyst should be considered. Transsphenoidal sinus resection is an effective treatment for this disease.