 There is a heterogeneously enhancing mass in the pituitary gland with infiltration into the clivus and extension into the right cavernous sinus, where there appears to be partial encasement of the internal carotid artery. The mass also extends into the sphenoid sinuses where there has interval decrease in size of an intrinsically high T1 and both high and low T2 hyperintense component with the sphenoid sinus, now measuring up to 18 mm in anteroposterior dimension, previously 24 mm. The infundibulum is slightly displaced to the left. There is no mass effect upon the optic apparatus.
Invasive pituitary macroadenoma with unchanged right cavernous sinus extension, but decrease in size and evolution of the signal characteristics in the sphenoid sinus component that likely contains subacute hemorrhage. 