Female, 41 years old, with history of pituitary adenoma status post resection x 2 at an outside facility, assess for growth. A lobular, T1 hyperintense and T2 hypointense lesion is redemonstrated occupying the sella and extending into the suprasellar cistern. The lesion does not appear to enhance above and beyond its intrinsic T1 hyperintensity. The lesion has perhaps changed shape slightly when compared to the prior examination, however the overall size is approximately similar. Due to differences in head positioning, the most accurate measurements are obtained in the sagittal plane where the lesion measures 22 x 16 mm (see image eight series 3), previously 22 x 16 mm. There may be a septation in the left anterior inferior portion of the lesion, but this is better visualized previously.The lesion extends into the suprasellar cistern, probably contacting the optic apparatus. No definite evidence of cavernous sinus invasion is seen. The native pituitary gland is not clearly visualized but a portion of it may be present along the right sellar floor. The pituitary stalk is not distinctly visualized as separate from the lesion.
A lobular lesion involving the sella and suprasellar cistern is redemonstrated showing no overall change in size though the shape of the lesion may have changed slightly. The nature of the lesion remains unclear. The particular signal characteristics of the lesion could reflect proteinaceous or mucoid secretions as well as blood product, each of which can be seen within a macroadenoma.