Clinical question: History of meningioma status post XRT. Signs and symptoms:As above. Pre-and post-enhanced pituitary MRI:Examination demonstrates a dural based extra-axial mass arising from the dorsal aspect of planum sphenoidale and the posterior and inferior extension into the sella. It measures a maximum of 22.8-mm in AP and 15-mm in cranial cephalad axis. The mass is larger on the right of the midline and results in slight elevation of the right frontal lobe and minimally of the left frontal. There is no evidence of signal abnormality of the adjacent parenchyma.The pituitary gland inferior to the tumor is identified and demonstrates subtle mass effect on the right from meningioma. Bilateral A1 segments of anterior or artery of elevated right mass. There is also last effect on the right cisternal portion optic nerve by the mass.Cavernous sinuses demonstrate normal signal intensity and pattern of enhancement and without evidence of tumor invasion. The proximal right supraclinoid internal carotid artery has extensive contact along its medial aspect with the meningioma however without evidence of encasement. Compared to prior exam there is no evidence of any change in the size, signal intensity, extent and uniform pattern of enhancement of tumor.
1.Stable size, signal intensity, extent and uniform pattern of enhancement of a meningioma arising from planum sphenoidale and with extension into the sella since prior exam.2.The mass arises slightly to the right of midline and with redemonstration of mass effect on the cisternal segment of right optic nerve and its contact with the supraclinoid right internal carotid artery without encasement.