A large soft tissue mass fills the enlarged pituitary fossa and extends superiorly into the suprasellar cisterns, where it elevates the optic chiasm. It measures 15 mm in anteroposterior diameter, 25 mm in height and 30 mm in width. It is of heterogeneous signal intensity, with low T2 signal and vivid contrast enhancement. It extends into the right cavernous sinus, but probably only laterally displaces the left cavernous sinus without definite MRI evidence of invasion. There is also a small anterior meningeal "tail" extending along the chiasmatic sulcus for a distance of 4 mm.
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 few small scattered foci of abnormal signal within the white matter of the cerebral hemispheres may represent chronic small vessel ischaemic disease.
Large pituitary mass with moderate superior displacement of optic chiasm and invasion of the right cavernous sinus. Most likely this represents a macroadenoma with necrosis and haemorrhage although the absence of high T1 signal components is a little unusual. An anterior contrast enhancing "tail" is unusual for pituitary macroadenoma and a meningioma is not excluded, although appearances would be unusual (both morphology and signal intensity).