Pituitary tumor: surveillance. Pituitary: There is a pituitary mass with suprasellar extension that measures up to 28 mm in craniocaudal dimension, which is not significantly changed. There is associated mass effect upon the optic chiasm and extension of tumor into the bilateral cavernous sinuses, without significant narrowing of the internal carotid artery flow voids. The tumor also has mass effect upon the infundibulum, hypothalamus, anterior commissure, and left medial temporal lobe.Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is encephalomalacia and gliosis in the right inferior frontal gyrus with a small amount of susceptibility effect. There are scattered foci of T2 hyperintensity in the cerebral white matter. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. Unchanged probable pituitary macroadenoma with mass effect upon the optic chiasm.2. Chronic right inferior frontal lobe infarct.