Male, 73 years old, history of sellar meningioma, s/p transphenoidal resection, follow-up surveillance imaging. A bulky, partially resected tumor is redemonstrated situated within and expanding the sella. The lesion remains T1 isointense and slightly T2 hyperintense relative to gray matter with fairly homogeneous enhancement.Slow interval growth of tumor is suspected, particularly in the right aspect of the lesion where there is some suggestion of cavernous sinus involvement. On coronal imaging, the tumor measures 21 x 14 mm (image 10 series 9) which compares to 18 x 11 mm in 2012. Comparison with the 2013 examination is less reliable due to motion artifact on that study.Although the tumor abuts both of the cavernous ICAs, there is no evidence of significant vascular narrowing. The right aspect of the suprasellar cistern is encroached upon by tumor similar to prior. The pituitary stalk deviates slightly towards the right and enters this rightward portion of the lesion. The optic chiasm and optic nerves are unaffected by the lesion.
Slow interval increase in the size of the residual sellar tumor, particularly when comparison is made over multiple prior exams.