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Anaesthetic challenges in a patient with acromegaly and multinodular goitre undergoing endoscopic pituitary surgery
  1. Jabraan Jamil1,
  2. Wan Mohd Nazarudin Wan Hassan2,
  3. Ab Rahman Ghani3 and
  4. Tat Boon Yeap2,4
  1. 1Anaesthesia and Intensive Care Unit, Hospital Queen Elizabeth, Kota Kinabalu, Malaysia
  2. 2Department of Anaesthesia and Intensive Care, Universiti Sains Malaysia, Kota Bharu, Malaysia
  3. 3Department of Neurosciences, Hospital Universiti Sains Malaysia, Kota Bharu, Malaysia
  4. 4Department of Anaesthesia and Intensive Care, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
  1. Correspondence to Dr Tat Boon Yeap; boontat{at}


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.

  • Anaesthesia
  • Pituitary disorders
  • Thyroid disease
  • Neuroanaesthesia

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  • Contributors WMNWH, TBY and ARG were the clinicians involved in patient management. JDJ and TBY participated in manuscript writing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.