Date : 00.00.00
Name of the Patient : Abc XyzTelmn / M / 40 yrs.
Referred by : Dr. Abc Xyza.
Examination : M.R.I. of the Sella & Perisellar Region.
CLINICAL PROFILE :
Known C/O pituitary adenoma. Detected in 0000. On Tablet Bromocryptine. No complaints at present.
For follow up.
M.R.I. of the sella and perisellar region was performed using the following parameters :4 mm thick T1 Weighted and T2 Weighted sagittal images. 4 mm thick T1 Weighted and T2 Weighted coronal images.The brain was screened with 5 mm thick T2 Weighted axial images. OBSERVATION :There is near complete destruction of the clivus and the sella.
There is seen a fairly large, predominantly cystic (hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images) in the region of the clivus and sella turcica. The lesion extends anteriorly into the floor of the anterior cranial fossa, which is eroded. Extension into the posterior ethmoidal air cells and right orbital apex is noted. Laterally there is indentation on the medial temporal pole on the right and extension into the right cavernous sinus. The cavernous segment of the right internal carotid artery is encased by the lesion but shows normal flow void signal. Mild lateral displacement of the cavernous segment of the left internal carotid artery is noted. The supraclinoid segments of the internal carotid arteries
bilaterally and the proximal anterior cerebral arteries are also encased by the lesion. Posteriorly the lesion extends upto the dorsum sella. Inferiorly there is erosion of the floor of the sphenoid sinus with probable extension of the lesion in the nasopharyngeal region.
The optic chiasma and the proximal optic nerves are pulled inferiorly by this lesion. Hyperintense signal on the T1 Weighted images of the posterior pituitary gland is not well-identified on this study. The pituitary stalk is also not well identified. The sphenoid sinus seems to be occupied by the cystic tumor.
No significant abnormality is detected in the brain parenchyma per se on this study.
Mucosal thickening is noted in the maxillary sinuses bilaterally.
IMPRESSION :In a known C/O an invasive pituitary adenoma, the MRI features now show a predominantly cystic lesion in the sella and perisellar region as described which is the sequelae of resolution of the previous pituitary adenoma.
As compared to the previous MRI dated 00.00.00 (Study No. 0000), there is further cystic degeneration of the lesion. The extent of the lesion is however unchanged.