Transphenoidal for pituitary adenoma: surveillance. There are postoperative findings related to transsphenoidal surgery. There is enhancing tumor within the sella, with extension into the right cavernous sinus and encasement of the internal carotid artery. The tumor measures up to 20 mm in height, 22 mm in length, and 21 mm in width. The pituitary stalk is intact, but deviated to the left. There is T2 hyperintensity and volume loss in the optic chiasm, but no mass effect upon the optic apparatus by the tumor. Rather, the supraclinoid right internal carotid artery segment abuts the prechiasmatic right optic nerve. The previously demonstrates sinonasal fluid has cleared, with residual small retention cysts in the bilateral maxillary sinuses. There are nonspecific scattered foci of T2 hyperintensity in the bilateral cerebral white matter.
Residual pituitary tumor with extension into the right cavernous sinus and encasement of the internal carotid artery, as well as evidence of chronic neuropathic changes in the optic chiasm.