{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:35:17Z","timestamp":1776134117298,"version":"3.50.1"},"reference-count":35,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,2,2]]},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2022-250640","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T10:25:16Z","timestamp":1676543116000},"page":"e250640","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Anaesthetic challenges in a patient with acromegaly and multinodular goitre undergoing endoscopic pituitary surgery"],"prefix":"10.1136","volume":"16","author":[{"given":"Jabraan","family":"Jamil","sequence":"first","affiliation":[{"name":"Anaesthesia and Intensive Care Unit, Hospital Queen Elizabeth, Kota Kinabalu, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wan Mohd Nazarudin","family":"Wan Hassan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Universiti Sains Malaysia, Kota Bharu, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ab Rahman","family":"Ghani","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Hospital Universiti Sains Malaysia, Kota Bharu, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2517-597X","authenticated-orcid":false,"given":"Tat Boon","family":"Yeap","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Universiti Sains Malaysia, Kota Bharu, Malaysia"},{"name":"Department of Anaesthesia and Intensive Care, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"2025082707493772000_16.2.e250640.1","first-page":"319","article-title":"Pituitary adenomas: an overview","volume":"88","author":"Lake","year":"2013","journal-title":"Am Fam Physician"},{"key":"2025082707493772000_16.2.e250640.2","first-page":"762","article-title":"Management of hormone-secreting pituitary adenomas","volume":"19","author":"Mehta","year":"2017","journal-title":"Neuro Oncol"},{"key":"2025082707493772000_16.2.e250640.3","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1530\/EJE-21-0216","article-title":"Global epidemiology of acromegaly: a systematic review and meta-analysis","volume":"185","author":"Crisafulli","year":"2021","journal-title":"Eur J Endocrinol"},{"key":"2025082707493772000_16.2.e250640.4","doi-asserted-by":"crossref","first-page":"R67","DOI":"10.1530\/EJE-19-1023","article-title":"MANAGEMENT of endocrine disease: does gender matter in the MANAGEMENT of acromegaly?","volume":"182","author":"Lenders","year":"2020","journal-title":"Eur J Endocrinol"},{"key":"2025082707493772000_16.2.e250640.5","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1007\/s11102-015-0701-2","article-title":"Incidence and prevalence of acromegaly in a large US health plan database","volume":"19","author":"Burton","year":"2016","journal-title":"Pituitary"},{"key":"2025082707493772000_16.2.e250640.6","doi-asserted-by":"publisher","DOI":"10.1093\/bjaceaccp\/mkr014"},{"key":"2025082707493772000_16.2.e250640.7","doi-asserted-by":"publisher","DOI":"10.1172\/JCI39375"},{"key":"2025082707493772000_16.2.e250640.8","doi-asserted-by":"crossref","DOI":"10.1186\/1756-0500-6-411","article-title":"Ectopic acromegaly due to a GH-secreting pituitary adenoma in the sphenoid sinus: a case report and review of the literature","volume":"6","author":"Ram\u00edrez","year":"2013","journal-title":"BMC Res Notes"},{"key":"2025082707493772000_16.2.e250640.9","doi-asserted-by":"crossref","DOI":"10.1155\/2012\/540398","article-title":"Clinical manifestations and diagnosis of acromegaly","volume":"2012","author":"Lugo","year":"2012","journal-title":"Int J Endocrinol"},{"key":"2025082707493772000_16.2.e250640.10","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1159\/000144046","article-title":"Biochemical evaluation of patients with active acromegaly and type 2 diabetes mellitus: efficacy and safety of the galanin test","volume":"88","author":"Mazziotti","year":"2008","journal-title":"Neuroendocrinology"},{"key":"2025082707493772000_16.2.e250640.11","doi-asserted-by":"crossref","first-page":"817","DOI":"10.4158\/EP11324.OR","article-title":"Serum IGF-1 in the diagnosis of acromegaly and the profile of patients with elevated IGF-1 but normal glucose-suppressed growth hormone","volume":"18","author":"Subbarayan","year":"2012","journal-title":"Endocr Pract"},{"key":"2025082707493772000_16.2.e250640.12","unstructured":"Lim CT , Khoo B . 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