Findings:
Centered within the left aspect of the pituitary gland is a well-defined cystic lesion (10 mm) with a 7 mm measuring hypointense intracystic nodule, which is mildly T1 hyperintense. Pituitary tissue is elevated upwards towards the left side of the optic chiasm, which is not yet contacted or compressed. On the postcontrast study a thin enhancing rim was identified, which could present the surrounding compressed pituitary tissue. Normally enhancing pituitary gland is draped over the anterior right aspect of the cyst with mild elevation and deviation of the infundibulum to the right of midline.
The cavernous sinuses are unremarkable.
The brain parenchyma is normal. No hydrocephalus or midline shift.
Mucosal thickening is seen in both maxillary sinuses. The paranasal sinuses mastoid recess are otherwise clear.
No bony abnormality is seen.
Conclusion:
10 mm measuring cystic pituitary lesion, which likely represents a Rathke cleft cyst in an off-midline location, DDX cystic/haemorrhagic pituitary macroadenoma. Mild suprasellar extension without chiasmal compression.