Yaiza B Molero Diez1*, Agustin Diaz Alvarez2 and Raquel Sanchis Dux1
1 Department of Anesthesiology and Pain Medicine, Complejo Asistencial de Zamora, Spain 2 Department of Anesthesiology and Pain Medicine, Complejo Asistencial Universitario de Salamanca, SpainFulltext PDF
Background: Thyroid-Stimulating Hormone (TSH) - secretory pituitary adenomas are a rare cause of hyperthyroidism. Nowadays, the treatment of choice is surgery. For that, patients must be euthyroid to avoid a possible thyrotoxic crisis during the surgery. We describe the following clinical case of a young woman who had transsphenoidal hypophysectomy for resection of TSH secretory pituitary macroadenoma. Case: A 35-year old female arrives at the emergency department with palpitations, tachycardia, and tremor in her distal hands. She was diagnosed with hyperthyroidism of central origin secondary to a pituitary tumor. Her thyroid function was optimized during her admission to avoid a thyrotoxic crisis intraoperatively, and she was scheduled for transsphenoidal resection, which was successful. After the surgery, the patient was taken to the Intensive Care Unit (ICU). Due to her excellent evolution, the patient was sent to the neurosurgery ward for follow up and postsurgical treatment without any incidences 24 h after her surgery. Four days later, the patient was discharged home fully recovered. Conclusion: TSH-secreting pituitary adenomas are a weird condition that requires a thorough and early diagnosis. Before surgery, adequate thyroid control will decrease the risk of a possible appearance of a thyroid storm, which can increase the mortality and morbidity of our patients.
Pituitary adenoma; Hyperthyroidism; Thyroid storm; TSH; Anesthesia; Balanced; Transsphenoidal resection
Molero Diez YB, Alvarez AD, Dux RS. Anesthetic Management for Resection of TSH - Secretory Pituitary Adenoma: A Case Report. Clin Surg. 2020; 5: 2977..