Rathke’s Cleft Cyst 

Rathke’s cleft cyst is a rare fluid-filled sac that typically develops in the pituitary gland. Though referred to as the pituitary “gland,” it is actually made up of two glands – the anterior and posterior, which join at the roof of the mouth, causing a depression called Rathke’s pouch. The cyst occurs when the pouch does not close in early fetal development, leaving behind a cleft that becomes filled with a clear, colorless liquid.



The pea-sized pituitary gland is located at the base of the brain, just behind the eyes, and is considered the control center for the body’s hormones. A Rathke’s cleft cyst is typically very small (less than two millimeters) and won’t cause any symptoms. But if it traps and retains more fluid, it will continue to grow. This can put pressure on the pituitary gland, optic chiasm (where the nerves of the eye meet) and hypothalamus, the nerve center that helps stimulate or inhibit many of your body’s key processes, including temperature, heart rate and blood temperature.

If that happens, symptoms may include:

  • Decreased sex drive
  • Erectile dysfunction (in men)
  • Infertility and cessation of menstrual periods (in women)
  • Mood swings or behavior changes
  • Vision problems
  • Weight changes


To help clarify your diagnosis, your doctor may order blood and urine tests to measure your hormone levels, or an MRI or CT scan to provide a detailed image of your pituitary.

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Treatment Options

Dr. Amin Kassam, vice president for Neurosciences at Aurora Health Care, explains the Expanded Endonasal Approach, a minimally invasive surgery technique.

Brain cyst treatment options vary. If the cyst is small and not causing problems, your doctor may recommend a “watch and wait” approach. For large Rathke’s cleft cysts, the best treatment is surgery. 

At Aurora, we offer an innovative procedure called the Expanded Endonasal Approach. EEA is a minimally invasive procedure in which the tumor is removed through the nasal passages, resulting in no incisions, a shorter hospital stay and faster recovery than with traditional surgery. During this procedure, a thin, lighted tube (an endoscope) is inserted through your nostrils, allowing your doctor to remove or drain the cyst without making an incision – and without risking injury to your brain.

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