Clinical question:? New metastases. Signs and symptoms: History of pituitary carcinoma now with new onset of right hand tremor No evidence of new hemorrhage, edema, mass-effect, midline shift or hydrocephalus. Changes at the level of the sella consistent with patient's past history of pituitary carcinoma remains is stable. Focal area of enhancing tissue along the medial aspect of right middle cranial fossa also remains a stable. Review of prior MRI examination from 7 -- 22 -- 2009 and CT of brain dated 7 -- 31 -- 2009 demonstrates this lesion and in comparison to the current exam no appreciable change is detected.
No definitive evidence of new findings since prior study of 7 -- 31 -- 2009.