How would you empirically manage a large sellar/suprasellar mass with encasement of the right cavernous and terminal internal carotid arteries?

Knowing the histology of the mass would really help in creating more accurate treatment recommendations. A biopsy of a sellar mass is usually accomplished by an endonasal-endoscopic transsphenoidal approach utilizing the expertise of an ENT surgeon and a skull-base neurosurgeon. However, in this case, the patient is unable to undergo surgery. While meningiomas can arise near the pituitary gland and optic nerves, specifically from the dura at the tuberculum sellae, diaphragm sellae, or planum sphenoidale, they are somewhat uncommon compared to pituitary adenomas but are a recognized cause of sellar tumors, accounting for about 10% of all meningiomas in some studies.

Firstly, I would at least check a panel of pituitary hormones to make sure t...