Prepare the tortellini according to package directions; drain.
Add the butter to a large skillet; cook the shrimp until almost cooked through; approximately 2 to 3 minutes.
Add the tomato, basil, garlic and horseradish; cook for another 1 to 2 minutes until the shrimp is cooked and is white/pink (not clear).
Stir in the flour; add the heavy cream and cheese; mix well; add the cooked tortellini; stir until all coated.
Sprinkle with extra cheese and chopped basil, for garnish.