Clinical question: Pituitary mass. Signs and symptoms: Pituitary mass. Pre- and postenhanced brain MRI: Examination demonstrated a pituitary macroadenoma on the left and with extension into the left cavernous sinus and subtle extension across the midline to the right. There is subtle elevation of pituitary secondary to macroadenoma however without extension into the basal cistern similar to prior exam. The macroadenoma measures approximately 19 mm in longest transverse axis at 19 mm on coronal postenhanced series compared to prior study measurement of 21.2 mm. The cranial cephalad axis of adenoma measures at 10.6 mm compared to prior study measurement of 10.7 mm. The pituitary gland and stalk are deviated to the right and without change since prior exam. There is no convincing evidence of any appreciable interval change in size, morphology or the signal intensity of this lesion since prior exam.Pre and postcontrast enhanced brain MRI:No diffusion-weighted abnormalities.Examination demonstrate normal anatomical development and the signal intensity of brain parenchyma on all MRI images. Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.No detectable abnormal parenchymal or leptomeningeal enhancement.Unremarkable calvarium and orbits without abnormal enhancement.
1.Stable pituitary macroadenoma in the sella on the left, extension into left cavernous sinus since prior study.2.Unremarkable pre and post enhanced brain MRI otherwise.