Rathkes pouch is a normal component of embryological development which eventually forms the pituitary gland. This pouch normally closes early in fetal development, but a remnant often persists as a cleft that lies within the pituitary gland. Occasionally, this remnant gives rise to a large cyst, called Rathkes cleft cyst (RCC), that causes symptoms. Symptomatic RCCs are relatively uncommon lesions, accounting for less than 1% of all primary masses within the brain.

RCCs can be seen at any age, although most are identified in adults. RCCs are usually asymptomatic and are found incidentally at autopsy or MR imaging. RCCs may also present with visual disturbances, symptoms of pituitary dysfunction, and headaches.

RCCs are diagnosed with MRI or CT scans of the brain or pituitary. Other possible diagnoses that are considered when a cystic mass is seen in the area of the pituitary include an arachnoid cyst, a cystic pituitary adenoma, or a craniopharyngioma. Symptomatic RCC warrant transsphenoidal surgical drainage and/or excision.