Varshney Neha, Kebede Amanuel A, Owusu-Dapaah Harry, Lather Jason, Kaushik Manu, Bhullar Jasneet S
Department of Pathology, University of Toledo Medical Center, Toledo, OH, USA.
Department of Radiology, University of Toledo Medical Center, Toledo, OH, USA.
J Kidney Cancer VHL. 2017 Aug 2;4(3):20-29. doi: 10.15586/jkcvhl.2017.88. eCollection 2017.
Von Hippel-Lindau syndrome (VHL) is a familial neoplastic condition seen in approximately 1 in 36,000 live births. It is caused by germline mutations of the tumor suppressor gene VHL, located on the short arm of chromosome 3. While the majority of the affected individuals have a positive family history, up to 20% of cases arise from mutations. VHL syndrome is characterized by the presence of benign and malignant tumors affecting the central nervous system, kidneys, adrenals, pancreas, and reproductive organs. Common manifestations include hemangioblastomas of the brain, spinal cord, and retina; pheochromocytoma and paraganglioma; renal cell carcinoma; pancreatic cysts and neuroendocrine tumors; and endolymphatic sac tumors. Diagnosis of VHL is prompted by clinical suspicion and confirmed by molecular testing. Management of VHL patients is complex and multidisciplinary. Routine genetic testing and surveillance using various diagnostic techniques are used to help monitor disease progression and implement treatment options. Despite recent advances in clinical diagnosis and management, life expectancy for VHL patients remains low at 40-52 years. This article provides an overview of the major clinical, histological, and radiological findings, as well as treatment modalities.
冯·希佩尔-林道综合征(VHL)是一种家族性肿瘤疾病,在每36000例活产婴儿中约有1例出现。它由位于3号染色体短臂上的肿瘤抑制基因VHL的种系突变引起。虽然大多数受影响个体有阳性家族史,但高达20%的病例是由突变引起的。VHL综合征的特征是存在影响中枢神经系统、肾脏、肾上腺、胰腺和生殖器官的良性和恶性肿瘤。常见表现包括脑、脊髓和视网膜的血管母细胞瘤;嗜铬细胞瘤和副神经节瘤;肾细胞癌;胰腺囊肿和神经内分泌肿瘤;以及内淋巴囊肿瘤。VHL的诊断基于临床怀疑,并通过分子检测得以证实。VHL患者的管理复杂且需要多学科协作。使用各种诊断技术进行常规基因检测和监测,以帮助监测疾病进展并实施治疗方案。尽管临床诊断和管理方面最近取得了进展,但VHL患者的预期寿命仍然较低,为40 - 52岁。本文概述了主要的临床、组织学和放射学发现以及治疗方式。