Consensus guideline for the diagnosis and management of pituitary adenomas in childhood and adolescence: Part 1, general recommendations.


Journal

Nature reviews. Endocrinology
ISSN: 1759-5037
Titre abrégé: Nat Rev Endocrinol
Pays: England
ID NLM: 101500078

Informations de publication

Date de publication:
09 Feb 2024
Historique:
accepted: 19 12 2023
medline: 10 2 2024
pubmed: 10 2 2024
entrez: 9 2 2024
Statut: aheadofprint

Résumé

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.

Identifiants

pubmed: 38336897
doi: 10.1038/s41574-023-00948-8
pii: 10.1038/s41574-023-00948-8
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. Springer Nature Limited.

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Auteurs

Márta Korbonits (M)

Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. m.korbonits@qmul.ac.uk.

Joanne C Blair (JC)

Alder Hey Children's Hospital, Liverpool, UK.

Anna Boguslawska (A)

Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland.

John Ayuk (J)

University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Justin H Davies (JH)

University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Maralyn R Druce (MR)

Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Jane Evanson (J)

Neuroradiology, Barts Health NHS Trust, London, UK.

Daniel Flanagan (D)

Plymouth Hospitals NHS Trust, Plymouth, UK.

Nigel Glynn (N)

Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Claire E Higham (CE)

The Christie NHS Foundation Trust, Manchester, UK.

Thomas S Jacques (TS)

Great Ormond Street Institute of Child Health, University College London, London, UK.
Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.

Saurabh Sinha (S)

Sheffield Children's and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

Ian Simmons (I)

The Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Nicky Thorp (N)

The Christie NHS Foundation Trust, Manchester, UK.

Francesca M Swords (FM)

Norwich and Norfolk NHS Foundation Trust, Norwich, UK.

Helen L Storr (HL)

Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Helen A Spoudeas (HA)

Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
University College London Hospitals NHS Foundation Trust, London, UK.

Classifications MeSH