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Rathke’s cleft cyst presenting as bilateral abducens nerve palsy

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Abstract

We present a patient with a Rathke’s cleft cyst who presented with rapidly progressive bilateral 6th nerve palsy. A 20-year-old woman with a history of cleft palate, hypertension, and hydronephrotic kidneys presented with a one month history of headache, associated with dizziness and diplopia on horizontal gaze. Examination was significant for profound bilateral 6th nerve palsies. Magnetic resonance imaging showed a hypodense mass that filled the sella and compressed the right cavernous sinus without contacting the optic chiasm. Pituitary function was normal. An endoscopic, transnasal transsphenoidal resection of the lesion was performed; microscopic examination revealed a Rathke’s cleft cyst. Surgical excision resulted in near complete resolution of the bilateral 6th nerve palsy. Rathke’s cleft cysts are an unusual cause of bilateral sixth nerve palsy and represent a potential cause of cranial neuropathy.

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Acknowledgments

We wish to thank the Melvin Burkhardt chair in neurosurgical oncology and the Karen Colina Wilson research endowment within the Brain Tumor and Neuro-oncology Center at the Cleveland Clinic Foundation for partial support and funding.

Competing interests statement

Each author declares that he or she has NO competing interests.

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Authors and Affiliations

  1. Department of Endocrinology, Diabetes and Metabolism, Endocrinology and Metabolism Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Vinni Grover & Amir H. Hamrahian

  2. The Department of Pathology and Laboratory Medicine, Cleveland Clinic, Cleveland, OH, USA

    Richard A. Prayson

  3. The Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, The Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Robert J. Weil

Authors
  1. Vinni Grover
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  2. Amir H. Hamrahian
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  3. Richard A. Prayson
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  4. Robert J. Weil
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Correspondence to Vinni Grover.

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Grover, V., Hamrahian, A.H., Prayson, R.A. et al. Rathke’s cleft cyst presenting as bilateral abducens nerve palsy. Pituitary 14, 395–399 (2011). https://doi.org/10.1007/s11102-009-0192-0

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  • DOI: https://doi.org/10.1007/s11102-009-0192-0

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