‘’Wait and See’’ as a Treatment Option for a Rathke’s Cleft Cyst Apoplexy in Pediatric Population: A Case Report

Abstract

Introduction: Rathke cleft cyst apoplexy is exceedingly rare, particularly in infants. The most prevalent clinical manifestations include headaches, visual field defects, and endocrine dysfunction. Treatment options range from surgery to conservative methods, taking into consideration the balance of benefits and risks, especially during critical life stages such as childhood. Case Presentation: We present the case of a 12-year-old boy admitted due to the recent onset of headaches and diabetes insipidus. Magnetic resonance imaging revealed Rathke cleft cyst apoplexy. Given the absence of compressive symptoms in a child at the early stages of puberty and without abnormalities in basic endocrine tests, a conservative strategy was employed, involving regular clinical, biological, and radiological follow-ups. The child experienced normal puberty without any endocrine deficiencies except for a partial growth hormone deficiency. Conclusions: For clinically asymptomatic children diagnosed with Rathke's cleft cyst apoplexy, adopting a conservative management approach is recommended, provided there is thorough clinical, biological, and radiological surveillance.