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A mass is present involving the right side of the pituitary fossa, adjacent sphenoid sinus, and bulging into possibly invades the right cavernous sinus. It is of intermediate T1 signal, demonstrates slightly heterogeneous contrast enhancement, and intermediate T2 signal, and is surrounded anteriorly by tract secretions within the sphenoid sinus. On dynamic contrast enhanced sequences normal pituitary enhancement is noted, and the mass demonstrates hypoenhancement compared to the remainder of the pituitary which appears to be abutting but somewhat separate.
CT (not shown) of the central base of skull demonstrates the bones to be destroyed, with communication of the right sided pituitary fossa with the right side of the sphenoid sinus. There is marked thinning/erosion of all surrounding bones with little if any bone remaining between the mass and the carotid inferolaterally, the optic canal anterosuperiorly, and the planum sphenoidale superiorly. No intracranial extension or dural enhancement is visible, and the mass does not extend into the left side of the sphenoid sinus. In some places bone appears somewhat remodelled rather than destroyed.
The remainder of the imaged brain (please note this study has been targeted to the pituitary, and as such the whole brain has not been imaged) appears unremarkable, other than an incidental cavum septum pellucidum and vergae.
Right-sided sphenoid sinus/pituitary mass. Somewhat unusual appearance and the differential is essentially between a metastasis or an unusual pituitary macroadenoma.