29 years, Female, status post trans-sphenoidal hypophysectomy. Examination is mildly motion degraded. Interval postsurgical changes of transsphenoidal hypophysectomy are seen. There appears to be near total resection involving the sellar and right suprasellar mass. There is residual mildly enhancing soft tissue along the right cavernous sinus wall compatible with small amount of residual tumor, with partial encasement of the right cavernous ICA suspected. This tissue measures approximately 6 mm in thickness in the transverse dimension. There is also more avidly enhancing soft tissue along the left lateral aspect of the resection cavity measuring approximately 3 to 4 mm in thickness also compatible with residual tumor, adjacent to normal pituitary tissue. Infundibulum is leftward displaced but improved in the interval. Optic chiasm is well decompressed. Paranasal sinus opacification, particularly the sphenoid sinuses compatible with postoperative change. Brain parenchyma is within normal limits for age. No restricted diffusion to suggest acute ischemia. No other intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. There is edema and enhancement involving the left frontotemporal as well as left lateral suboccipital scalp which may postsurgical.
Interval postsurgical changes of transsphenoidal hypophysectomy with near total resection of the sellar and suprasellar tumor. Residual tumor is noted in the sella along the lateral aspects of the resection cavity bilaterally with suspected invasion of the right cavernous sinus. The right-sided residual tumor enhances to a lesser degree than on the left which may be related to prior necrosis. Optic chiasm is well decompressed.