Findings:
A sizable well defined avidly enhancing mass in the anterior pituitary, which expands the sellar cavity and displaces the posterior pituitary bright spot to the right. The lesion measures approximately 17 x 16 x 14.5 mm. This abuts and mildly compresses the optic chiasm. The intracavernous internal carotid arteries abut the mass laterally. Possible invasion of the left cavernous sinus. The infundibulum is deviated to the right.
Mild-to-moderate, background small vessel ischaemic disease is seen. The brain parenchyma is otherwise unremarkable. There is no hydrocephalus or midline shift.
Partial obliteration of the mastoid air cells is seen on the left side. The paranasal sinuses and the mastoid air cells are otherwise clear.
Conclusion:
Stable appearance of the known pituitary macroadenoma with mild chiasmal compression and possible invasion of the left cavernous sinus.