New suprasellar mass with visual loss, try to identify where mass is originating from for possible neurosurgical intervention. There is a homogeneously enhancing, dural-based mass along the posterior planum sphenoidale with extension into the sella and underlying hyperostosis, which measures approximately 29 mm anteroposteriorly, 25 mm transversely, and 18 mm craniocaudally. The mass mildly indents the superior surface of the pituitary gland and the anterior surface of the infundibulum. There is no evidence of intrinsic pituitary lesions. In addition, the mass displaces the prechiasmatic optic nerves laterally and abuts the optic chiasm and bilateral paraclinoid internal carotid arteries. There is a small patchy area of subcortical T2 hyperintensity in the posterior right gyrus rectus. There is mild diffuse periventricular white matter T2 hyperintensity, which is nonspecific, but may represent chronic small vessel ischemia. There are also small areas of encephalomalacia in the bilateral posterior occipital lobes, which may be the results of prior ischemia or trauma. There is no evidence of acute infarction. There is no midline shift or herniation. There is mild diffuse cerebral volume loss. Aside from hyperostosis along the sphenoid roofs, the paranasal sinuses are unremarkable. There is mild deviation of the anterior nasal septum to the left. There is prominence of the bilateral superior ophthalmic veins, which is nonspecific. There appears to be left frontal scalp scarring.
A dural-based planum sphenoidal mass with extension into the sella above the pituitary gland that measures up to 29 mm likely represents a meningioma. The mass mildly indents the superior surface of the pituitary gland and the anterior surface of the infundibulum, displaces the prechiasmatic optic nerves laterally and abuts the optic chiasm, and is associated with mild vasogenic edema in the posterior right gyrus rectus.