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Case Reports
. 2023 Feb 16;16(2):e250640.
doi: 10.1136/bcr-2022-250640.

Anaesthetic challenges in a patient with acromegaly and multinodular goitre undergoing endoscopic pituitary surgery

Jabraan Jamil  1 , Wan Mohd Nazarudin Wan Hassan  2 , Ab Rahman Ghani  3 , Tat Boon Yeap  4   5
Affiliations
Case Reports

Anaesthetic challenges in a patient with acromegaly and multinodular goitre undergoing endoscopic pituitary surgery

Jabraan Jamil et al. BMJ Case Rep. .

Abstract

Acromegaly is a progressive systemic disorder which is common among middle-aged women. A functioning growth hormone-secreting pituitary adenoma is the most common cause. Anaesthesia for pituitary surgery in patients with acromegaly is challenging. Rarely, these patients may develop thyroid lesions that may compromise the airway. We present the case of a young man with newly diagnosed acromegaly caused by a pituitary macroadenoma complicated by a large multinodular goitre. The aim of this report is to discuss the perianaesthetic approach in patients with acromegaly with a high risk of airway compromise undergoing pituitary surgery.

Keywords: Anaesthesia; Neuroanaesthesia; Pituitary disorders; Thyroid disease.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Pectus excavatum of the patient’s chest.
Figure 2
Figure 2
Brain MRI of the patient showing pituitary macroadenoma.
Figure 3
Figure 3
High-resolution CT of the thorax showing retrosternal mass encapsulating the trachea.
Figure 4
Figure 4
Postoperative CT of the brain showing remnants of the pituitary tumour.
See this image and copyright information in PMC

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