Multiplanar images were obtained without and with contrast. The craniocervical junction is within normal limits. There is a pituitary mass predominantly along the right and centrally, measuring 2.3 cm CC x 2.4 cm AP x 1.6 cm transverse. The mass has an ovoid configuration with a superior convex border. The mass does deviate the stalk to the left. The mass enhances with contrast and does extend along the superior and inferior surface of the right carotid artery. The mass is fairly homogeneous on T1 pre- and post-contrast images and again enhances homogeneously. The ventricles are symmetric. There are no other masses, mass effects or shift of midline structures. There is some mild high signal on the T2 weighted axial images in the right mastoid air cell suggestive of some mild infectious, inflammatory-type process. The IACs are symmetric. There is no evidence of an intraorbital mass. The globes are symmetric. The recti muscles are symmetric. Optic nerves are unremarkable as well. There are postsurgical changes in the sphenoid sinus.
IMPRESSION: Large mass involving the pituitary gland that is more right sided, measuring approximately 2.3 x 2.4 x 1.6 cm and causes deviation of the stalk to the left. This is suggestive of a recurrent macroadenoma. The mass does extend along the superior and inferior aspect of the right carotid artery.