The Rathke cleft cyst (RCC) is a fluid-filled and epithelium-lined developmental abnormality at posterior portion of anterior pituitary gland, which is usually symptomless but can give origin to headache, visual disturbances, hypopituitarism, and thyroid disorders; these cysts are prevalent in women and the incidental diagnosis is frequent.1-13 The peak incidence of RCCs is between 30 and 50 years,7 and is the main benign lesion located between the adeno- and the neurohypophysis.8 The structure of the Rathke's pouch was described by Martin Heinrich Rathke in 1838,9 and the RCCs origin from the Rathke's pouch obliteration failure during the embryological phase,4 being a common condition reported in up to 33% of autopsies; and, excluding functional adenomas, represent up to 28% of incidental pituitary masses detected by imaging study.2 Pituitary lesions occur in over than 10% of population, and near 1 among 1000 people present symptomatic tumors with mass effect, hypersecretion, or function impairment.4,6 The differential diagnosis of RCCs includes other cystic lesions of the pituitary region, as craniopharyngiomas, arachnoid cysts, epidermoid cysts, and cystic pituitary adenomas.13 RCCs treatment include hormone replacement, gonadotropin suppression, and surgery; cysts with less than 10 mm rarely grow and the follow-up can be restricted to 5 years.3,4,7 However, postoperative remnants or recurrent cysts need long-term imaging follow-up.7 Surgical approaches include endoscopic endonasal (transsphenoidal and transethmoidal) routes, that raise concerns about the prevention against SARS-Cov-2 dissemination.14-17 The aim is comment on the RCCs in general and the current role of COVID-19 infection.
