Findings:
Small well-defined cyst of the right lacrimal gland of homogeneous fluid content with no solid component, measuring approximately 1.1 cm. On the postcontrast study a thin rim enhancement is seen, which likely correlates with the lacrimal gland enhancement. Several foci of T1 and T2 signal void are seen surrounding the cystic lesion, possibly in keeping with calcifications or foreign bodies. No enhancement of the optic nerves.
Bilateral IOL-implant in situ.
Unchanged to the previous study a fluid intensity mass is seen within the right sphenoid sinus, measuring approximately 1 cm and showing connection to the sella (SE 2, IM 12-13), suspicious of a transsphenoid meningocele. The cavernous sinuses are unremarkable.
Moderate involutional changes are seen in the brain parenchyma in the form of prominent cortical sulci and widened ventricles. There is no midline shift.
Mild background small vessel ischaemic disease. The brain parenchyma is otherwise unremarkable.
Partial obliteration of the mastoid air cells is seen bilaterally. The paranasal sinuses are clear.
Conclusion:
Known cystic lesion of the right lacrimal gland without obvious solid components or enhancement, likely in keeping with a dacryops. Histological evaluation to rule out adenoid cystic carcinoma is advised.
Possible transsphenoid meningocele. Further evaluation with CT skull base is advised.