Clinical question: Pituitary macroadenoma, assess for change. Signs and symptoms: Pituitary macroadenoma. Pre-and post-enhanced pituitary MRI: Examination demonstrates no interval change since prior study.The signal intensity of the pituitary gland is within normal and without detectable internal focus of abnormality.Tortuous bilateral cavernous carotids demonstrate mass effect on the pituitary bilaterally similar to prior exam. There is uniform enhancement of pituitary gland and with normal position, size and pattern of enhancement the pituitary stalk similar to prior study. The maximum cranial cephalad axis of pituitary in midline measures at 12.5-mm. This measurement is similar to prior study.Possibility of uniformly enlarged pituitary gland or microadenoma should be considered however this finding could at least be partially secondary to mass effect on the pituitary by tortuous cavernous carotids. Correlate with patient's history and laboratory workup for better assessment.Cavernous sinuses are unremarkable otherwise. Basal cisterns and suprasellar visual complex is unremarkable.
1.No evidence of interval change since prior exam.2.Stable size of pituitary and pattern of enhancement since prior study.3.Apparent uniformly larger than expected size of pituitary gland although could represent a macroadenoma possibility of this finding being at least partially secondary to mass effect by tortuous bilateral internal carotid arteries should also be considered. Correlate with history, symptomatology and serologic studies.4.Unremarkable suprasellar visual complex, basal cistern and bilateral cavernous sinuses otherwise.