Reason: pituitary adenoma, sp resection 6 month follow up , eval for changes History: 6 month follow up. Postoperative changes related to transsphenoidal surgery. An enhancing pituitary mass encasing the right cavernous carotid artery without vessel narrowing is unchanged. There is again extension into the suprasellar cistern. The size is stable from the prior exam measuring 2.4 x 2.2 x 3.0 cm, previously 2.4 x 2.1 x 3.2 cm, but again slightly increased since the exam of 7/17/2014. Associated mass effect on the atrophic chiasm and optic nerves is unchanged. The infundibulum remains deviated to the left, similar to the prior exam.There is no evidence of intracranial hemorrhage or acute infarct. Scattered punctate periventricular and subcortical T2 hyperintensities are unchanged. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull and extracranial soft tissues are unchanged, including postoperative findings of the right parotid.
1.Recurrent pituitary adenoma is stable in size from the prior exam but slightly progressed since 7/17/2014.2.Scattered T2 hyperintensities likely reflect chronic small vessel ischemic disease and are unchanged.