54-year-old male with history of pancreatic cancer, coagulopathy, and liver failure presents with headache, altered mental status, left eye pain with unreactive dilated pupil There is a well demarcated, hyperattenuating sellar mass (image 9, series 2) which is consistent with a pituitary macroadenoma. There also appears to be a separate additional expansile mass in the sella (image 8, series 2) eroding the left posterior clinate and dorsum sella with minimal expansion into the left cerebello-pontine angle and significant extension into the left cavernous sinus with associated lateral expansion of the cavernous sinus. The mass shows hyperattenuation along the periphery with a hypoattenuating center. Although this second mass likely represents extension of the pituitary macroadenoma, an MRI is recommended for further evaluation and to exclude aneurysm. These masses are unlikely to represent metastases. There is no evidence of intracranial hemorrhage. The orbits appear within normal limits.The ventricles and basal cisterns are normal in size and configuration. With the exception of the dorsal sella and posterior clinate, the remaining calvaria and skull base are radiographically normal. A left maxillary retention cyst is noted. The other visualized paranasal sinuses and mastoid air cells are normally pneumatized.
Sellar masses with posterior and left lateral cavernous sinus extension as described above. These masses likely represent pituitary macroadenomas, MRI is recommended for further characterization and to exclude the diagnosis of aneurysm.Left maxillary retention cyst.