A brain mri found a 4x6cm lesion in the puitary gland described as a microadenoma. two weeks later a pituitary mri shows an 1.06x1.53 cm area of heterogenous gland described as a evolving pituitary adenoma or apoplexy. what is an evolving adenoma?

Pituitary tumor: evolving meant changing/growing. apoplexy is bleeding into tumor that can cause severe headache and even shock but can be more indolent. Pituitary adenomas can aslo grow during pregnancy.

More Likely Apoplexy: The orig MRI likely read 4 x 6 mm which is a common size for a pit adenoma. Usually slow growing / 2 week later MRI suggests you had some new or worsening symptoms. An evolving adenoma is one that is growing, that rate would be very odd for an adenoma (2-3 X in 2 weeks), but poss, esp if preg. In apoplexy the tumor basically bleeds into itself and usually goes away, also more com in preg.

My reaction: Cannot be fully precise as do not have direct films to view, but sounds like an expanding lesion, and the term "apoplexy" is very bothersome, as that suggests a nasty evolution. You need to see a neurosurgeon, and a baseline endocrinological "pituitary reserve" blood profile is required. Do not delay, get this moving.