A Comprehensive Review of Rathke’s Cleft Cysts: Diagnostic Challenges and Management Trends

Introduction and purpose: Rathke’s cleft cysts (RCCs) are benign, epithelium-lined lesions located in the sellar or suprasellar region, originating from remnants of Rathke’s pouch. While often asymptomatic and discovered incidentally, RCCs may lead to significant clinical symptoms due to compression of adjacent structures, including the pituitary gland and optic chiasm. The aim of this review is to provide a comprehensive overview of RCCs and emphasize the importance of accurate diagnosis and individualized management, especially in symptomatic cases. Material and methods: The review is based on scientific literature published between 2005 and 2025, retrieved from PubMed, Scopus and Google Scholar using the following keywords: “Rathke’s cleft cyst,”, “Rathke’s cyst diagnosis,” “Rathke’s cyst treatment,” “pituitary cyst surgery,” and “Rathke’s cyst recurrence”. Results: Analysis of the literature indicates that although most RCCs remain asymptomatic, a significant subset causes symptoms such as headaches, visual disturbances, and endocrine dysfunction. MRI remains the most effective diagnostic tool, while treatment typically involves transsphenoidal surgical drainage. Recurrence rates vary depending on the surgical technique and inflammatory changes within the cyst wall. Emerging approaches, such as steroid-eluting stents, show promise in reducing recurrence, though further research is needed. Conclusions: RCCs, though generally benign, may result in substantial morbidity in symptomatic patients. Accurate diagnosis, appropriate imaging, and tailored treatment are essential for optimal outcomes. Long-term follow-up is recommended due to the potential for recurrence, and novel interventions offer promising avenues for future management strategies.