Female, 65 years old, with known pituitary mass, receiving periodic follow-up at outside hospital, transitional care to CMC. Marked cystic expansion of the sella is demonstrated with bony remodeling suggestive of chronicity. The fluid resembles CSF on all sequences. The native pituitary gland is displaced and flattened along the floor and left lateral aspect of the sella. The pituitary gland appears to enhance normally. No evidence of any solid nodular or enhancing mass is seen. The pituitary infundibulum enhances normally and deviates towards the left. On limited views of the brain, scattered nonspecific T2 hyperintense lesions are seen within the parenchyma. A cavum vellum interpositum is also noted incidentally.
Cystic expansion of the sella is demonstrated with mass effect upon the pituitary gland but no obvious solid or enhancing masses. This finding may simply represent the effects of chronically elevated intracranial pressure such as might be seen with idiopathic intracranial hypertension. Other possibilities would include a Rathke cleft cyst or intrasellar arachnoid cyst though these are considered less likely.