Female, 69 years old, history of pituitary adenoma status post resection and radiation. Heterogeneously enhancing tissue is redemonstrated within the sella compatible with the stated history. As before, components of this tumor are suspected to be present bilaterally within the sella, within the right cavernous sinus, and questionably within the left cavernous sinus. The portion of the tumor which resides in the right half of the sella and right cavernous sinus is not as discretely visualized as on the prior examination, but this may represent differences in imaging technique.The overall size of the abnormal tissue is stable to slightly smaller. The left aspect of the tumor measures up to 12 mm in height, including a portion which encroaches upon the sphenoid sinus, previously 13 mm in height. In the sagittal plane, the lesion measures 24 x 12 mm, previously 27 x 13 mm. The left sellar aspect of the lesion demonstrates more discrete central hypoenhancement than on the prior exam.Minimal encroachment upon the suprasellar cistern is again seen. The optic apparatus is not well visualized which may reflect some degree of atrophy or imaging artifact. The pituitary stalk continues to deviate towards the right.Again seen is an apparently separate dural based mass along the left anterior clinoid process and sphenoid wing which is unchanged in size measuring 15 x 4 mm in the coronal plane. This lesion abuts the supraclinoid left ICA without significant vascular compromise. Extensive confluent periventricular T2 hyperintensityand parenchymal volume loss are partially imaged similar to prior.
1. Sellar tumor is stable to slightly smaller with interval increased central hypoenhancement on the left. Findings may represent response to treatment or differences in imaging technique.2. Apparently separate dural based mass along the left anterior clinoid and sphenoid wing is unchanged in size, possibly representing a meningioma.