Recent resection of pituitary adenoma (on Feb 5, 2016) with residual mass on the left side. Recent seizure in the setting of hyponatremia. Assess for recurrent, enlarging mass. The midline and slightly eccentric to the left, well-circumscribed, heterogeneously predominantly peripherally contrast-enhancing tissue, which measures up to 12 mm, has not changed since the previous examination. Also, a smaller, more posteriorly located component, which is located along the medial aspect of the left cavernous sinus measuring approximately 7 x 5 mm, is unchanged. These 2 areas were contiguous on the initial preoperative study. Pituitary infundibular deviation to the right is unchanged. Enhancement involving the right lateral aspect of the sella likely represents residual normal pituitary tissue.While the larger residual mass still has suprasellar extension, there continues to be no significant mass-effect. In fact, there is unchanged inferior displacement and thinning of the floor of the third ventricle and the optic chiasm. There are other changes related to previous transsphenoidal approach, including fat-intensity packing material.Also, the two adjacent enhancing extra-axial masses along the left superior frontal convexity meningioma are unchanged. Included brain shows unchanged volume loss.
1.Unchanged residual tissue in the sella and along the medial aspect of the posterior left cavernous sinus compatible with residual macroadenoma.2.Unchanged left frontal convexity meningiomas.