Acromegaly associated with a symptomatic Rathke's cyst

Our aim is to describe a case of acromegaly that was associated with symptomatic Rathke's cyst. We describe a young male student without any significant family history who presented with clinical and biochemical features consistent with growth hormone excess, which was confirmed with dynamic testing. He also described a persistent headache predating symptoms of growth hormone excess by 4 years. Magnetic resonance imaging (MRI) of the pituitary showed a large sellar mass which was thought to be a somatotroph adenoma. Trans-sphenoidal surgery was performed; however, a colloid lesion was identified by the neurosurgeon that proved to be a Rathke's cyst. The association of acromegaly with Rathke's cyst is very rare, with less than 10 cases found to be reported on review of literature. This is the first report from India.