Clinical question: History of pituitary adenoma status post resection. Signs and symptoms: Surveillance scan. Again seen is previously debulked, enhancing sellar mass consistent with known pituitary macroadenoma. Compared to 7/16/2014, there appears to be minimal interval increase in size, measuring approximately 37 x 36 x 26 mm in the AP, transverse, and craniocaudal dimensions, previously 30 x 34 x 24 mm. Signal features are similar to prior with slight change in size of cystic areas. As seen before, anterior extension results in obliteration of the sphenoid sinus. Superiorly, there is no significant suprasellar extension and no mass effect on the optic chiasm. Mild tenting of the optic chiasm is again noted consistent with postsurgical change. Infundibulum is rightward deviated, similar to prior. Lateral extension on the left into the left cavernous sinus with partial encasement of the left cavernous internal carotid artery is again seen without narrowing of the left ICA caliber.Limited evaluation of the remainder of the brain again demonstrates enlargement of the lateral ventricles, particularly the right frontal horn, stable to minimally decreased in size in the interval. Scattered foci of T2 hyperintensity in the white matter also again seen and may represent small vessel ischemic changes.
1. Compared to 7/16/2014, there is minimal interval increase in size of the sellar mass consistent with known pituitary macroadenoma as detailed above. There is no mass effect on the optic chiasm.2. Ventriculomegaly is again seen and stable to minimally improved compared to prior.