Rathke Cleft cyst (RCC)
Rathke's Cleft Cyst (RCC)
A Rathke's Cleft Cyst (RCC) is a rare, benign (non-cancerous), fluid-filled cyst that develops in or near the pituitary gland. Many RCCs are discovered incidentally during MRI scans performed for other reasons and often do not cause symptoms or require treatment.
Most Rathke's Cleft Cysts remain small and stable throughout life. However, larger cysts can occasionally cause symptoms by putting pressure on the pituitary gland, pituitary stalk, or nearby optic nerves.
Symptoms
Many people with a Rathke's Cleft Cyst have no symptoms. When symptoms do occur, they may include:
one deficiencies (hypopituitarism)
Weight gain
Difficulty concentrating
Changes in menstrual cycles
Reduced libido or sexual dysfunction
Breast discharge (galactorrhoea)
Visual disturbances or loss of Headaches
Hormperipheral vision
Symptoms usually occur when the cyst becomes large enough to affect normal pituitary function or compress nearby structures.
Diagnosis
Rathke's Cleft Cysts are most commonly diagnosed using an MRI scan of the pituitary gland. Patients may also undergo:
Hormone blood tests
Endocrinology assessment
Vision and visual field testing
Anyone diagnosed with an RCC should be assessed by a specialist pituitary multidisciplinary team (MDT), which may include endocrinologists, neurosurgeons, ophthalmologists, radiologists, and specialist nurses.
Treatment
Treatment depends on the size of the cyst and whether symptoms are present.
Observation and Monitoring
Many small RCCs do not require treatment and can be safely monitored with:
Regular endocrinology reviews
Hormone testing
MRI scans when appropriate
Visual assessments if required
Hormone Replacement Therapy
If the cyst affects pituitary hormone production, hormone replacement therapy may be prescribed to treat any hormone deficiencies.
Surgery
Surgery may be recommended if the cyst is causing:
Visual problems
Significant hormone dysfunction
Persistent headaches that do not respond to medical treatment
Progressive growth of the cyst
The most common operation is transsphenoidal surgery, where the cyst is accessed through the nose. This avoids external scars and is the standard surgical approach for most pituitary conditions.
Recovery and Outcomes
Surgical outcomes are generally very good. Many patients experience improvement in vision, headaches, and symptoms caused by pressure on surrounding structures.
As with any operation, there are potential risks, which should be discussed fully with your neurosurgical team before treatment.
Follow-Up and Long-Term Monitoring
Even after successful treatment, long-term follow-up may be recommended.
Patients may require:
Periodic MRI scans
Hormone blood tests
Endocrinology reviews
Visual assessments
Although Rathke's Cleft Cysts are benign, they can occasionally recur over time. Regular monitoring helps ensure any changes are detected early and managed appropriately.
Support and Information
At Pituitary Ireland, we provide information, support, and signposting to trusted resources for people living with Rathke's Cleft Cysts and other pituitary conditions. If you have concerns about your diagnosis or treatment, please speak with your endocrinologist, neurosurgeon, or specialist healthcare team.