Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China.
J Neurosurg. 2014 Oct;121(4):846-50. doi: 10.3171/2014.3.JNS131837. Epub 2014 Apr 11.
Rathke's cleft cysts (RCCs) are benign cysts typically located in the sellar or suprasellar region; ectopic isolated lesions are extremely rare. The authors describe the case of a 25-year-old man with a giant symptomatic RCC arising primarily at the cerebellopontine angle (CPA), only the second case reported thus far. The patient presented with a 2-year history of right hearing impairment and tinnitus accompanied by vertigo and headache and a 2-week history of right facial numbness. Subsequently, he underwent total cyst removal via retrosigmoid craniotomy with a good recovery. He experienced no recurrence during a 64-month follow-up period. The possible pathogenesis, differential diagnosis, and surgical treatment of such cysts are discussed in this article. Isolated ectopic RCCs can arise from the ectopic migration of Rathke's pouch cells during the embryonic period. It is still difficult to distinguish ectopic RCCs from other cystic lesions of the CPA given the lack of specific imaging features. Aggressive resection of the cyst wall is not recommended, except when lesions do not closely adhere to adjacent structures.
拉克氏囊肿（Rathke's cleft cysts，RCC）是一种良性囊肿，通常位于蝶鞍或鞍上区域；异位孤立性病变极为罕见。作者描述了一例 25 岁男性的巨大症状性 RCC，主要发生在桥小脑角（CPA），这是迄今为止报告的第二例。患者表现为右耳听力障碍和耳鸣 2 年，伴有眩晕和头痛，以及右侧面部麻木 2 周。随后，他通过乙状窦后颅窝开颅术进行了全囊肿切除术，恢复良好。在 64 个月的随访期间，他没有复发。本文讨论了此类囊肿的可能发病机制、鉴别诊断和手术治疗。孤立性异位 RCC 可能是胚胎期 Rathke's 囊细胞异位迁移所致。由于缺乏特定的影像学特征，仍然难以将异位 RCC 与 CPA 的其他囊性病变区分开来。除非病变与相邻结构不紧密粘连，否则不建议积极切除囊肿壁。
