The pituitary fossa is expanded with deficiency of its floor. A heterogeneous mass occupies the remodelled sella and extends inferiorly into the sphenoid sinus. The infundibulum is displaced posteriorly and toward the left. There is superior extension into the suprasellar cistern with elevation and compression of the optic chiasm and right optic nerve. No cavernous sinus extension.
Most of the mass has heterogeneous high T2 signal and is T1 isointense with vivid enhancement. However there also multiple cystic foci within the lesion, a few with intrinsic T1 hyperintensity. No large T2 hypointense component.
Conclusion: Sellar and suprasellar mass with optic chiasm and right optic nerve compression, but no cavernous sinus invasion. This is most likely to be pituitary macroadenoma.