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Consensus guideline for the diagnosis and management of pituitary adenomas in childhood and adolescence: Part 1, general recommendations
Nature Reviews Endocrinology ( IF 40.5 ) Pub Date : 2024-02-09 , DOI: 10.1038/s41574-023-00948-8
Márta Korbonits , Joanne C. Blair , Anna Boguslawska , John Ayuk , Justin H. Davies , Maralyn R. Druce , Jane Evanson , Daniel Flanagan , Nigel Glynn , Claire E. Higham , Thomas S. Jacques , Saurabh Sinha , Ian Simmons , Nicky Thorp , Francesca M. Swords , Helen L. Storr , Helen A. Spoudeas

Tumours of the anterior part of the pituitary gland represent just 1% of all childhood (aged <15 years) intracranial neoplasms, yet they can confer high morbidity and little evidence and guidance is in place for their management. Between 2014 and 2022, a multidisciplinary expert group systematically developed the first comprehensive clinical practice consensus guideline for children and young people under the age 19 years (hereafter referred to as CYP) presenting with a suspected pituitary adenoma to inform specialist care and improve health outcomes. Through robust literature searches and a Delphi consensus exercise with an international Delphi consensus panel of experts, the available scientific evidence and expert opinions were consolidated into 74 recommendations. Part 1 of this consensus guideline includes 17 pragmatic management recommendations related to clinical care, neuroimaging, visual assessment, histopathology, genetics, pituitary surgery and radiotherapy. While in many aspects the care for CYP is similar to that of adults, key differences exist, particularly in aetiology and presentation. CYP with suspected pituitary adenomas require careful clinical examination, appropriate hormonal work-up, dedicated pituitary imaging and visual assessment. Consideration should be given to the potential for syndromic disease and genetic assessment. Multidisciplinary discussion at both the local and national levels can be key for management. Surgery should be performed in specialist centres. The collection of outcome data on novel modalities of medical treatment, surgical intervention and radiotherapy is essential for optimal future treatment.



中文翻译:

儿童和青少年垂体腺瘤诊断和治疗共识指南:第 1 部分,一般建议

垂体前部肿瘤仅占所有儿童(年龄 <15 岁)颅内肿瘤的 1%,但其发病率很高,且缺乏治疗证据和指导。 2014 年至 2022 年间,多学科专家组系统地制定了第一个针对疑似垂体腺瘤的 19 岁以下儿童和青少年(以下简称 CYP)的综合临床实践共识指南,为专业护理提供信息并改善健康结果。通过大量文献检索以及国际德尔菲共识专家小组的德尔菲共识演习,现有的科学证据和专家意见被整合为 74 条建议。该共识指南的第 1 部分包括 17 条与临床护理、神经影像、视觉评估、组织病理学、遗传学、垂体手术和放射治疗相关的实用管理建议。虽然 CYP 的护理在许多方面与成人相似,但存在关键差异,特别是在病因学和表现方面。疑似垂体腺瘤的 CYP 需要仔细的临床检查、适当的激素检查、专门的垂体成像和视觉评估。应考虑综合征性疾病的可能性和遗传评估。地方和国家层面的多学科讨论可能是管理的关键。手术应在专科中心进行。收集有关新的医疗、手术干预和放射治疗方式的结果数据对于未来最佳治疗至关重要。

更新日期:2024-02-10
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