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Lobulated enhancing sellar/suprasellar mass has a rounded component occupying the sella (difficult to distinguish from normal pituitary tissue) with thickening enhancement of the pituitary infundibulum is displaced on the left, and a second rounded component of the mass at the superior infundibulum/hypothalamus.
The posterior aspect of the optic chiasm is contacted by the hypothalamic component of the mass without compression.
No evidence of cavernous sinus invasion. The flow voids of both cavernous internal carotid arteries are preserved.
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.
A whole brain axial post contrast sequence demonstrates no further intracranial pathological enhancement.
The sellar mass extending along infundibulum to hypothalamus is an unusual configuration for a macroadenoma. Given the history of breast carcinoma, metastasis must be the major diagnostic consideration.
Lymphocytic hypophysitis, histiocytosis and granulomatous hypophysitis are less likely possibilities given the clinical context.