Pituitary Tumors Composed of Adenohypophysial Adenoma and Rathke's Cleft Cyst Elements

Rathke's cleft cysts are believed to be derived from remnants of Rathke's pouch, a dorsal invagination of the stomodeum. Although these cysts are characteristically small, asymptomatic and intrasellar in location, they occasionally provoke symtoms with enlargement to compress surrounding structures. It is characteristically lined by stratified squamous epithelium with keratinization on a layer of connective tissue. The cells of the anterior pituitary lobe, from which pituitary adenomas develop, are also formed by the proliferation of the anterior wall of Rathke's pouch. Thus, Rathke's cleft cyst and pituitary adenomas are considered to have a common ancestry. We report a rare case in which the preoperative diagnosis was pituitary adenoma, but the pathologic diagnosis was a combination of a Rathke's cleft cyst and a coincidental pituitary adenoma.

Unusual Anterior Arch Fracture of C1

Fractures of C1 are not uncommon, constituting only 10% of all cervical spine injuries. There is a high prevalence of concomitant fractures of the second and first cervical vertebral complex. Surgical treatment is controversal. Mainstay of treatment is various combination of traction and cervical orthosis according to degree of displacement and location of fracture. We experienced unusual type of fracture, anterior arch fracture of C1 who had a history of total laminectomy of C1,2 due to cervical cord tumor(neurilemmoma arising from C2 root). We performed C1,2 lateral mass screw fixation with posterior fusion with good postoperative outcome.