Rathke Cleft Cysts in Identical Twins

Rathke cleft cysts are congenital, non-neoplastic sellar cysts derived from remnants of embryonic Rathke pouch. Presentation of Rathke cleft cysts can be incidental; however, in larger cysts, presentation can be with headaches, visual deterioration, and pituitary and endocrine dysfunction. Here we report a rare case of identical twin boys with Rathke cleft cysts, highlighting the likely genetically driven development of cyst in this identical twin and need for cranial imaging in identical twins with anomalies of the brain.