Von Hippel-Lindau disease: Genetics and role of genetic counseling in a multiple neoplasia syndrome

Sarah M. Nielsen*, Lindsay Rhodes, Ignacio Blanco, Wendy K. Chung, Charis Eng, Eamonn R. Maher, Stéphane Richard, Rachel H. Giles

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Von Hippel-Lindau disease (VHL) is one of the most common inherited neoplasia syndromes and is characterized by highly vascular tumors of the eyes, brain, and spine, as well as benign and malignant tumors and/or cysts of the kidneys, adrenal medullae and sympathetic paraganglia, endolymphatic sac, epididymis, and broad ligament. Since the discovery of the VHL gene in 1993, more than 900 families with VHL have been identified and examined. Genetic testing for VHL is widely available and will detect a disease-causing mutation in rate 95% to 100% of individuals who have a clinical diagnosis of VHL, making it the standard of care for diagnosis of VHL. Furthermore, genetic testing for VHL is indicated in some individuals with seemingly sporadic VHL-related tumor types, as ≤ 10% of pheochromocytoma or early-onset renal cell carcinoma and ≤ 40% of CNS hemangioblastoma harbor germline VHL mutations without a family history or additional features of VHL disease. The majority of VHL mutations are private, but there are also well-characterized founder mutations. VHL is a complex, multiorgan disease that spans the breadth of oncology subspecialties, and, as such, providers in these subspecialties should be aware of when to consider a diagnosis of VHL, when to refer a patient to a genetics specialist for consideration of gene testing, and, perhaps most importantly, how to communicate this sensitive information in an age-appropriate manner to at-risk families. This review will provide state-of-the-art information regarding the genetics of VHL and will serve as a key reference for nongenetics professionals who encounter patients with VHL.

Original languageEnglish
Pages (from-to)2172-2181
Number of pages10
JournalJournal of clinical oncology
Volume34
Issue number18
Early online date25 Apr 2016
DOIs
Publication statusPublished - 20 Jun 2016

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