Fungsional Makroadenoma Hipofisis dengan Manifestasi Akromegali dan Komplikasi Diabetes Insipidus Pascaoperasi

Abstract

Acromegaly as a clinical manifestation of functional pituitary macroadenoma is a rare case. A 28-year-old male was consulted with a space occupying suprasellar cerebral lesion with a differential diagnosis of meningioma or adenoma which would require tumor resection. On the pre-operative examination, it was found that patients with signs and symptom of acromegaly such as a more prominent jaw, the size of the nose, tongue, and hands were relatively larger than normal people but without symptoms of obstructive sleep apnea. Intraoperatively, the patient was successfully intubated with a video laryngoscope with a fiber optic preparation. Post-operatively the patient developed diabetes insipidus and was transferred to the room from ICU on the seventh postoperative day when she was free of vasopressin. There are several things that should be considered during the perioperative management of patients with pituitary macroadenoma, such as airway management if there is acromegaly and diabetes insipidus as a postoperative complication.