Schmeling Kristine, Schuh Jennifer, Lal Dave, Becktell Kerri
Department of Pediatrics, Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, USA.
Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Case Rep Oncol. 2024 Nov 14;17(1):1309-1315. doi: 10.1159/000541527. eCollection 2024 Jan-Dec.
Von Hippel-Lindau (VHL) is a diagnosis that leads to increased risk of tumor development over the course of a patient's lifetime. Patients with VHL undergo screening for multiple tumor types, including pheochromocytomas (PCCs). There is variability among the different international guidelines regarding the age to begin PCC screening, with most suggesting 5 years for screening initiation.
Our patient is a 4-year-old female who underwent screening for PCC at the time of her VHL diagnosis while asymptomatic that identified a unilateral PCC. This was amendable to treatment with laparoscopic partial adrenalectomy.
This is the first report of an asymptomatic PCC being identified in a patient under the age of 5. With early identification, this was treated surgically before it caused systemic symptoms with preservation of normal adrenal gland tissue. This supports adhering to the pediatric specific guidelines which recommend earlier initiation of PCC screening in pediatric patients with VHL.
冯·希佩尔-林道病(VHL)是一种会使患者一生中患肿瘤风险增加的疾病。VHL患者需要对多种肿瘤类型进行筛查,包括嗜铬细胞瘤(PCC)。不同的国际指南对于开始PCC筛查的年龄存在差异,大多数指南建议在5岁开始筛查。
我们的患者是一名4岁女性,在VHL诊断时无症状,接受了PCC筛查,结果发现单侧PCC。这适合通过腹腔镜肾上腺部分切除术进行治疗。
这是首次报告在5岁以下患者中发现无症状PCC。通过早期识别,在其引起全身症状之前进行了手术治疗,同时保留了正常肾上腺组织。这支持遵循儿科特定指南,该指南建议对患有VHL的儿科患者更早开始PCC筛查。