Pituitary adenomas are rare in children and young people under the age of 19 (hereafter referred to as CYP) but they pose some different diagnostic and management challenges in this age group than in adults. These rare neoplasms can disrupt maturational, visual, intellectual and developmental processes and, in CYP, they tend to have more occult presentation, aggressive behaviour and are more likely to have a genetic basis than in adults. Through standardized AGREE II methodology, literature review and Delphi consensus, a multidisciplinary expert group developed 74 pragmatic management recommendations aimed at optimizing care for CYP in the first-ever comprehensive consensus guideline to cover the care of CYP with pituitary adenoma. Part 2 of this consensus guideline details 57 recommendations for paediatric patients with prolactinomas, Cushing disease, growth hormone excess causing gigantism and acromegaly, clinically non-functioning adenomas, and the rare TSHomas. Compared with adult patients with pituitary adenomas, we highlight that, in the CYP group, there is a greater proportion of functioning tumours, including macroprolactinomas, greater likelihood of underlying genetic disease, more corticotrophinomas in boys aged under 10 years than in girls and difficulty of peri-pubertal diagnosis of growth hormone excess. Collaboration with pituitary specialists caring for adult patients, as part of commissioned and centralized multidisciplinary teams, is key for optimizing management, transition and lifelong care and facilitates the collection of health-related quality of survival outcomes of novel medical, surgical and radiotherapeutic treatments, which are currently largely missing.

垂体腺瘤在 19 岁以下的儿童和青少年（以下简称 CYP）中很少见，但与成人相比，该年龄组的诊断和治疗面临一些不同的挑战。这些罕见的肿瘤会破坏成熟、视觉、智力和发育过程，并且在 CYP 中，它们往往具有更多的隐匿性表现、攻击性行为，并且比成人更有可能具有遗传基础。通过标准化的 AGREE II 方法、文献综述和德尔菲共识，多学科专家组制定了 74 条务实的管理建议，旨在优化 CYP 的护理，这是第一个全面的共识指南，涵盖了 CYP 合并垂体腺瘤的护理。该共识指南的第 2 部分详细介绍了针对患有泌乳素瘤、库欣病、生长激素过量导致巨人症和肢端肥大症、临床无功能腺瘤和罕见 TSHoma 的儿科患者的 57 条建议。与成年垂体腺瘤患者相比，我们强调，在 CYP 组中，功能性肿瘤（包括泌乳素大腺瘤）的比例更高，潜在遗传性疾病的可能性更大，10 岁以下男孩比女孩更多的促肾上腺皮质激素瘤，并且治疗困难青春期生长激素过多的诊断。作为委托和集中多学科团队的一部分，与照顾成年患者的垂体专家合作是优化管理、过渡和终身护理的关键，并有助于收集新型内科、外科和放射治疗的与健康相关的生存质量结果，这目前大部分失踪。