Páleníková Patrícia, Adamcová Monika, Šturdík Igor, Ftáčniková Beáta, Copáková Lucia, Payer Juraj
Vnitr Lek. 2016 Winter;62(12):1004-1008.
Von Hippel-Lindau syndrome (VHL) is a rare genetic disease. Its incidence is 1 : 36,000, there is the familial occurrence in 80 % of cases , the remaining cases are de novo mutations. The disease is caused by the highly penetrant mutations in the VHL gene (3p25.3) and is characterized by the occurrence of benign and malignant neoplasms. The most common VHL tumors are the tumors of the retina, brain and spinal hemangioblastomas, renal cell carcinoma, pheochromocytoma, endolymfatic sac tumors and pancreatic tumors and cysts. The mean age of the VHL patients during the diagnosis is 20-40 years. The diagnosis can be confirmed by a positive family history and the presence of one of the typical tumor. In case of no family history, the diagnosis has to be assessed by the presence of the multiple tumors. The clinical signs and prognosis of VHL depend on the location and extent of the tumors. The life expectancy is 50 years. The most common causes of death are complications of the renal cancer and the brain tumors. The treatment requires a multidisciplinary collaboration through the whole life of patients. This 2 cases report we demonstrate the differences among the patients with de novo mutations disease and the patient with familial incidence.Key words: pheochromocytoma - renal cell carcinoma - von Hippel-Lindau syndrome.
冯·希佩尔-林道综合征(VHL)是一种罕见的遗传性疾病。其发病率为1:36000,80%的病例有家族聚集性,其余病例为新发突变。该疾病由VHL基因(3p25.3)的高穿透性突变引起,其特征是出现良性和恶性肿瘤。最常见的VHL肿瘤是视网膜肿瘤、脑和脊髓血管母细胞瘤、肾细胞癌、嗜铬细胞瘤、内淋巴囊肿瘤以及胰腺肿瘤和囊肿。VHL患者确诊时的平均年龄为20至40岁。通过阳性家族史和存在一种典型肿瘤可确诊。若无家族史,则必须通过存在多种肿瘤来评估诊断。VHL的临床体征和预后取决于肿瘤的位置和范围。预期寿命为50岁。最常见的死亡原因是肾癌和脑肿瘤的并发症。治疗需要在患者的整个生命过程中进行多学科协作。在本两例报告中,我们展示了新发突变疾病患者与家族性发病患者之间的差异。关键词:嗜铬细胞瘤 - 肾细胞癌 - 冯·希佩尔-林道综合征