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CT head COMPLEX unenhanced/enhanced Clinical indication: Ongoing chronic headache since head injury 2 years ago. Technique: Volumetric acquisition was obtained through the brain with and without the use of intravenous contrast. Comparison/correlation: None Findings: There is a large homogeneous mass involving the sellar, right parasellar, and suprasellar brain with smooth bony expansion and fairly homogeneous enhancement following contrast administration. There are small locules of fat density along the superolateral aspect of the lesion. There is encasement and ill-definition of the right ICA. There is mass effect upon the regional cisterns and upon the 3rd ventricle. Comparison/correlation: None Findings: There is a large homogeneous mass involving the sellar, right parasellar, and suprasellar brain with smooth bony expansion and fairly homogeneous enhancement following contrast administration. There are small locules of fat density along the superolateral aspect of the lesion. There is encasement and ill-definition of the right ICA. There is mass effect upon the regional cisterns and upon the 3rd ventricle but no significant hydrocephalus. This large mass measures approximately 5.4 x 5.0 x 4.2 cm. The differential diagnosis rests with pituitary macroadenoma, meningioma, or other brain neoplasm. A vascular etiology is thought less likely, but there is vascular encasement. Correlation with any outside studies is recommended. The posterior fossa is unremarkable. There are no significant herniation syndromes at this time. Mild mucosal disease involves the paranasal sinuses. The calvarium is intact. Opinion: Large homogeneously enhancing sellar/parasellar/suprasellar mass with vascular encasement demonstrating regional mass effect and vascular encasement. This could represent pituitary macroadenoma, meningioma, or other brain neoplasm. Relatively urgent neurosurgical consultation and enhanced MRI brain are recommended