History of surgery for pituitary tumor, yearly follow up for change. There is a T2 hyperintense, enhancing lesion within the right anterolateral aspect of the sella, which displaces and compresses the normal pituitary tissue posteriorly, and measures up to 12 x 11 x 9 mm in the AP, transverse, and craniocaudal dimensions. There is no significant change in size allowing for differences in technique. The lesion bulges slightly into the medial aspect of the right cavernous sinuses and abuts the supraclinoid portion of the right internal carotid artery, without clear evidence of cavernous sinus invasion. There is no mass effect upon the optic apparatus. The pituitary infundibulum is intact, but displaced to the left, as before. The posterior pituitary bright spot is diminished but present. Limited evaluation of the brain again demonstrates scattered foci of T2 hyperintensity in the white matter which are nonspecific but compatible with mild small vessel ischemic disease.
Enhancing pituitary mass involving the right anterior lateral aspect of the sella demonstrates no significant change in size since 1/21/2015 and is compatible with residual macroadenoma. There is interval increased enhancement evident within this lesion, which is favored to be related to differences in contrast dose and timing. 