Left visual loss related to a large pituitary adenoma status post debulking on 6/23/15: surveillance imaging. There are postoperative findings related to transsphenoidal surgery for debulking of a pituitary macroadenoma. There is a residual enhancing mass that measures up to approximately 25 mm centered in the left sella with extension into the left cavernous sinus with partial encasement of the left internal carotid artery, which is not significantly changed, accounting for differences in technique. There also appears to be invasion of the left clivus. There is high T2 signal and perhaps mild volume loss of the optic chiasm. However, there is no discernible mass effect upon the optic apparatus by the pituitary mass. There are persistent secretions and mucosal thickening within the sphenoid sinuses.
Postoperative findings related to transsphenoidal surgery for debulking of a pituitary macroadenoma with residual tumor into the left cavernous sinus with partial encasement of the left internal carotid artery. While there is apparent encephalomalacia in the optic chiasm, there is no evidence of mass effect upon the optic apparatus.