Clinical question: History of pituitary adenoma. Signs and symptoms: Surveillance scan. Pre and post enhanced pituitary MRI:Examination redemonstrate residual pituitary adenoma within the left lateral aspect of the sella and with extension into the left cavernous sinus and partial encasement of the left internal carotid artery. On coronal post enhanced images the maximum craniocaudal cephalad axis of tumor measures at 23.4 mm which is nearly identical to prior exam. Expanded left cavernous sinus and tumor on the left lateral aspect of the due to measures maximum of 15.3 mm in transverse axis which is also identical to prior study. The caliber of the internal carotid artery remains within normal.There is significant rightward deviation of pituitary stalk which terminates to the right lateral aspect of expanded sella similar to prior exam. There is no detectable mass within the basal cistern. There is inferior herniation of the suprasellar visual complex inferiorly likely as a result of treatment and scarring which also remain similar to prior exam.
1.Stable size, signal intensity and extent of residual pituitary adenoma within the left lateral aspect of sella and with extensive extension into the left cavernous sinus as detailed.2.Adhesion of the pituitary stalk to the right lateral wall of expanded sella similar to prior exam.3.Inferior herniation of the suprasellar visual complex as result of treatment remain similar to prior study as well. 