Clinical question: Transsphenoidal surgery with persistent subcentimeter lesion within the right pituitary gland. Signs and symptoms: Yearly follow-up. Pre- and post enhanced pituitary MRI:Examination redemonstrates a partially cystic mass in the right side of sella with suggestion of subtle extension into the right cavernous sinus. Compared to prior exam there is no convincing evidence of any change in the signal intensity or size of this lesion.All the measurements of pituitary gland remain nearly identical to prior study. Associated mass effect with this finding evident by leftward deviation of the pituitary stalk remains also identical to prior study. The largest craniocephalad measurement of dictated at 8.8 mm is identical to prior exam.There is no detectable mass within the basal cistern and no evidence of mass effect on the suprasellar visual complex.Pre and post enhanced brain MRI:Negative diffusion weighted images.FLAIR images demonstrate a few punctate nonspecific hyperintensities in the subcortical and periventricular white matter without change since prior exam and without evidence of enhancement. Unremarkable cerebral cortex, cortical sulci, ventricular system and CSF spaces otherwise and stable since prior exam. No detectable abnormal parenchymal or leptomeningeal enhancement.Unremarkable calvarium and orbits without abnormal enhancement.
1.Pituitary MRI demonstrate stable right-sided pituitary lesion in size, signal intensity and extend since prior study.2.Brain MRI demonstrate no acute intracranial process, stable few nonspecific nonenhancing punctate FLAIR hyperintensity in the subcortical and periventricular white matter and stable unremarkable exam otherwise.