くも膜囊胞との鑑別が困難であった症候性Rathke's cleft cystの1例

Symptomatic Rathke's Cleft Cyst Mimicking Suprasellar Arachnoid Cyst

Ⅰ．はじめに

　Rathke's cleft cystはトルコ鞍内に局在するもの，ないし鞍内から鞍上部に伸展した鞍上部伸展型がほとんど⁴⁾であり，鞍上部に限局したものはentirely suprasellar Rathke's cleft cystと呼ばれ，比較的稀^1,6,12)である．今回われわれは，くも膜下腔に沿って伸展し，くも膜囊胞との鑑別が困難であった症候性entirely suprasellar Rathke's cleft cystの1例を経験したので文献的考察を含め報告する．

The authors report an atypical case of symptomatic entirely suprasellar Rathke's cleft cyst mimicking suprasellar arachnoid cyst. A 55-year-old male was introduced to our hospital complaining of bitemporal hemianopsia. CT and MRI demonstrated a cystic mass located entirely in the suprasellar cistern and to compress the optic nerve and mammillary body. The cystic wall was not enhanced in MRI. CT cisternography showed the suprasellar non-communicating cyst with cistern. The hormonal function was slightly disturbed by the pituitary compression. Under the diagnosis of suprasellar arachnoid cyst,a left front temporal craniotomy was performed to resect the suprasellar mass. The surgical specimen consisted ciliated epithelium and was diagnosed Rathke's cleft cyst. After operation,he recovered completely free.