Reason: h/o suprasellar meningioma History: surveillance There is redemonstration of a homogeneously enhancing slightly lobulated dural based mass along the posterior planum sphenoidale with extension into the suprasellar cistern. It currently measures 1.5 cm transverse x 1.5 cm CC x 2.0 cm AP, compared to previous 1.5 x 1.5 x 1.9 cm, respectively. Comparing to outside remote exam from February 2013, there has been no significant interval change allowing for differences in technique, with only perhaps very slight increased size. There is again significant mass effect upon the optic chiasm and pituitary tissue within the sella. There is abutment of the right cavernous sinus without frank invasion. There is similar degree of abutment of the supraclinoid right internal carotid artery as well as the bilateral A1 segments.The ventricles and sulci are prominent, consistent with mild age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with mild chronic small vessel ischemic changes. There is no new pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
Continued stable appearance of planum sphenoidale/suprasellar enhancing extra-axial mass most compatible with meningioma, with similar degree of localized mass effect on the optic chiasm and pituitary tissue. Compared back to baseline 2013 exams, minimal if any increase in size.