Findings:
Sizable, enhancing sellar and supra-sellar mass lesion, measuring approximately 22 x 23 x 35 mm.
Laterally, the mass invades the cavernous sinuses bilaterally, encasing the left internal carotid artery, which remains patent.
Inferiorly, expanding the sellar cavity and its floor compressing both sphenoid sinuses with intra-sinus extension, more significant on the left.
Superiorly, it is elevating and compressing the optic chiasm.
The intracranial arteries are patent.
An area of encephalomalacia is seen in the right fronto-orbital region, likely posthaemorrhagic in nature. A small chronic lacune is seen in the right thalamus. Moderate background small vessel ischaemic disease.
Moderate involutional changes are seen in the brain parenchyma in the form of prominent cortical sulci and widened ventricles. No hydrocephalus or midline shift.
The mastoid air cells on the paranasal sinuses are otherwise clear. Right-sided IOL-implant in situ.
Conclusion:
Pituitary microadenoma with chiasmal compression, intra-sinus extension and invasion of the cavernous sinuses.