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

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


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.

Publication types

  • Case Reports

MeSH terms

  • Acromegaly* / complications
  • Acromegaly* / surgery
  • Adenoma* / complications
  • Adenoma* / pathology
  • Adenoma* / surgery
  • Anesthetics*
  • Female
  • Goiter* / complications
  • Goiter* / surgery
  • Growth Hormone-Secreting Pituitary Adenoma* / complications
  • Growth Hormone-Secreting Pituitary Adenoma* / surgery
  • Humans
  • Male
  • Middle Aged
  • Neuroendoscopy
  • Pituitary Neoplasms* / complications
  • Pituitary Neoplasms* / surgery


  • Anesthetics