Follow-up surveillance evaluation. History of pituitary adenoma status post resection x 2. Again seen are postoperative changes related to prior pituitary tumor resections. There is stable to minimal enlargement of the residual pituitary adenoma involving the right aspect of the sella, for example measuring up to 16 mm in the transverse dimension and 10 mm in the craniocaudal dimension, coronal T2 image 10, previously 15 x 9 mm re-measured similarly. AP dimension of approximately 12 mm is not significantly changed. Diminished central hypoenhancement involving the mass is again seen and likely reflective of prior treatment. The optic chiasm is tented downward with the infundibulum rightward deviated, as seen before and consistent with postoperative change. Thinning of the optic chiasm is again demonstrated. No mass effect on the optic chiasm is present. The mass abuts the right aspect of the cavernous sinus without clear evidence of invasion.Partially imaged brain demonstrates scattered foci of T2 hyperintensity involving the periventricular and subcortical white matter grossly similar to prior and compatible with small vessel ischemic changes. No evidence of intracranial mass effect, midline shift, or hydrocephalus.
Stable to minimal increase in size of the residual pituitary adenoma compared to 4/15/2015 involving the right aspect of the sella with measurements as above. No mass effect on the optic chiasm.