Diagnosis: Benign neoplasm of pituitary gland and craniopharyngeal duct (pouch)Clinical question: h/o pituitary adenoma; pre surgical planningSigns and Symptoms: pre op planning The CSF spaces are appropriate for the patient's stated age with no midline shift. There is asymmetric enhancement in the pituitary fossa with a 12 x 9 mm axial dimension lesion centered in the left half of the pituitary fossa extending towards the left cavernous sinus. It has some suprasellar extension.A cystic lesion is present adjacent to the left temporomandibular joint.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate minor mucosal thickening in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.
1.There is a mass present centered in the left pituitary gland extending towards the left cavernous sinus and across the midline which most likely represents a pituitary adenoma. It has some suprasellar extension.2.Examination is limited for the purpose of stereotactic guidance during surgery.