Transphenoidal for pituitary tumor resection. Evaluate for residual/recurrent tumor. There are postoperative findings related to prior transphenoidal surgery. There has been gradual increase in size of the enhancing right sellar mass with extension into the right cavernous sinus, which now measures 19 AP x 17 RL x 13 SI mm. The mass encases the right cavernous portion of the internal carotid artery. However, there is no mass effect upon the optic apparatus. The infundibulum intact and midline. There are partially imaged prominent arachnoid granulations in the bilateral greater sphenoid wings.
Gradual increase in size of the pituitary macroadenoma over the course of several years.