Male, 37 years old, with pituitary tumor. On this limited evaluation for surgical planning purposes, a large heterogeneously T2 hyperintense lesion is evident involving the sella and suprasellar cistern. The lesion appears to invade both the sphenoid bone and the cavernous sinuses. The lesion projects superiorly indenting the brain up to the level of the foramen of Monro. The lesion is centrally nonenhancing with a thin rim of faint enhancement and a small nodule of enhancement at its superior most margin. It is difficult to determine whether the optic nerves pass through or around the lesion, though the optic chiasm is not clearly visualized and may be engulfed. The ICAs pass along the margins of this tumor. The left ICA flow void is intact. The right ICA flow void is not well seen through the region of the cavernous sinuses, though the terminal ICA and MCA branches do show typical flow voids. No other enhancing lesions are seen. No significant parenchymal edema is detected.
A large mass is evident involving the sella and suprasellar cistern with encroachment into the sphenoid bone, cavernous sinuses, and the undersurface of the brain. The lesion demonstrates thin peripheral enhancement with a small nodule of enhancement at its superior most margin.