48-year-old female with recurrent non-secreting pituitary adenoma status post surgery x 2 as well as radiation therapy. Redemonstrated is a stable postoperative appearance of the pituitary gland with the pituitary stalk shifted to the right and the pituitary gland smaller on the right than on the left. As before, a defect is noted along the right side of the floor of the sella likely indicating the site of surgical approach. There is asymmetric pituitary enhancement with bandlike enhancement of the right side of the pituitary appearing similar to prior studies. There is no mass effect or areas of new enhancement identified. Non-pneumatization of the sphenoid sinus is again noted. Limited visualization of the brain parenchyma demonstrate no mass lesion or midline shift. There is redemonstration of borderline cerebellar tonsillar ectopia with the inferior tip of the cerebellar tonsils measuring approximately 4 mm below the level of the foramen magnum.
Stable postoperative changes of the pituitary as described primarily involving the right side of the sella without significant interval change compared to prior studies.