What does the relatively rapid growth of the solid component suggest?
Although it may relate merely to decompression of the cyst above it, if growth is real then it raises the possibility of malignant degeneration of the solid component or an immature component.
There is significant increase in the size of the solid component of the suprasellar tumour in comparison with last MRI. It shows irregular margin and measures now about 31 x 28.5 x 26.7 mm. It remains suprasellar in location with no intrasellar extension. It is hypointense on T1 and hyperintense on T2/FLAIR It shows homogeneous intense enhancement. There is no evidence of diffusion restriction. There is significant reduction in the size of the cystic component, seen superior and right lateral aspects to the mass lesion compared to the last MRI, in keeping with shunt drainage.
Previously noted small component of high T1/T2 signal intensity extends just posterior to the right posterior clinoid process.
The mass displaces the pituitary stalk to the right side and optic chiasm lies just anterior to it, with splayed optic tracts and swollen hyperintense right optic nerve adjoining the chiasm.
Ventricle remain decompressed by the shunt catheters. The tip of right parietal shunt is within the frontal horn of right lateral ventricle. The tip of right frontal shunt is seen within the left temporal horn of left lateral ventricle, after crossing the tumour's posterolateral margin.