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

## TL;DR

A 12-year-old boy with Rathke's cleft cyst apoplexy was managed conservatively with regular monitoring and showed normal development.

## Contribution

This case report suggests conservative management as a viable option for asymptomatic pediatric Rathke's cleft cyst apoplexy.

## Key findings

- The child experienced normal puberty with only partial growth hormone deficiency.
- Conservative management with monitoring was effective in the absence of compressive symptoms.
- No surgical intervention was needed during the follow-up period.

## Abstract

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.

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.

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.