avid enhancement. The mass does not appear to arise from the pituitary gland. It causes mass effect on the anterior midbrain and pons, and compresses and inferiorly displaces the optic chiasm. It also causes mass effect on the circle of Willis including basilar apex, bilateral P1 segments of the posterior cerebral arteries, carotid terminus, bilateral A1 segments of the ACA and anterior communicating artery. No acute hemorrhage or infarction.
Ventricles and extra-axial spaces: Mild bilateral lateral ventricular enlargement, may be due to outflow obstruction from above described mass upon the foramina of Monro. There is also mass effect on the third ventricle as above. Fourth ventricle is normal in size.
Overall ventricular size and configuration is unchanged from prior examination.
Visualized paranasal sinuses: Clear.
Mastoid air cells: Clear.
Additional comment: None.
1. Large 3.4 x 3.7 x 4.4 cm T2 hyperintense avidly enhancing mass involving the anterior third ventricle, hypothalamus and suprasellar
cistern. Leading differential considerations would include papillary type craniopharyngioma versus chordoid glioma, less likely astrocytoma or germ cell tumor.
2. Lesion causes mass effect on the optic chiasm, circle of Willis, third ventricle and foramina of Monro with mild lateral ventriculomegaly.