Macroadenoma status post resection and XRT in 2008. There are postoperative findings related to transsphenoidal surgery. There is tumor within the bilateral cavernous sinuses with encasement of the cavernous carotid arteries and tumor along the floor of the sella. There is also enhancing globular enhancing material just inferior to the sella within the sphenoid sinuses. Overall, the tumor spans approximately 4.0 cm in width and 2.5 cm in height. However, there is no significant narrowing of the carotid arteries. Tumor abuts the bilateral optic canals and the bilateral supraclinoid carotid arteries abut the prechiasmatic optic nerves. The infundibulum is intact, but deviated to the right.
Residual tumor within the bilateral cavernous sinuses with encasement of the cavernous carotid arteries and tumor along the floor of the sella. Globular enhancing material just inferior to the sella within the sphenoid sinuses may represent tumor extension or a nasoseptal flap.