I am not a doctor so I can only give you guesses and what I know from my experience.
The way this is worded, the radiologist is not sure exactly what the lesion (be it tumor, cyst etc) is and so you may have to have more testing or imaging. It is located in an area where it may be impacting mood and it is close the the optic nerves. You also have what is called "empty sellla syndrome" where the sella appears empty. The sella is where the pituitary sits and that can also impact mood and many other things, and that requires specialized testing.
The wording about "congenital" to me means that this lesion has been present since birth, and but he cannot exclude other things.
You need more testing. More imaging. Do keep us posted.