J Pediatr Genet 2016; 05(02): 116-123
DOI: 10.1055/s-0036-1579757
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Von Hippel–Lindau Disease

Jennifer J. Findeis-Hosey
1   Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States
,
Kelly Q. McMahon
2   Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States
3   Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States
,
Sarah K. Findeis
4   The Pennsylvania State University School of Medicine and Dentistry, Hershey, Pennsylvania, United States
› Author Affiliations
Further Information

Publication History

15 July 2015

10 August 2015

Publication Date:
04 April 2016 (online)

Abstract

Von Hippel–Lindau disease is an autosomal dominant syndrome which occurs secondary to germline mutations in the VHL tumor suppressor gene, located on chromosome 3. Clinically von Hippel–Lindau disease is characterized by an increased risk of developing simple visceral cysts, most commonly in the pancreas and kidneys, in addition to an increased risk of developing neoplasms, often with clear cell features, in a multitude of organ systems. The most common neoplasms are cerebellar and retinal hemangioblastomas, adrenal pheochromocytomas, clear cell renal cell carcinomas, pancreatic neuroendocrine tumors, pancreatic serous cystadenomas, and endolymphatic sac tumors. These lesions most commonly present during adulthood; however, screening and surveillance for the development of these lesions should begin in the pediatric years for patients with von Hippel–Lindau disease. In this review article, the genetics and most common neoplasms of von Hippel–Lindau disease are reviewed, with an eye towards implications for the pediatric patient.

 
  • References

  • 1 Neumann HPH, Zbar B. Renal cysts, renal cancer and von Hippel-Lindau disease. Kidney Int 1997; 51 (1) 16-26
  • 2 von Hippel E. Über eine sehr seltene Erkrankung der Netzhaut. Graefe Arch Ophthalmol 1904; 59: 83-106
  • 3 Lindau A. Zur Frage der Angiomatosis Retinae und Ihrer Hirncomplikation. Acta Ophthalmol 1927; 4: 193-226
  • 4 Maher ER, Neumann HP, Richard S. von Hippel-Lindau disease: a clinical and scientific review. Eur J Hum Genet 2011; 19 (6) 617-623
  • 5 Friedrich CA. Genotype-phenotype correlation in von Hippel-Lindau syndrome. Hum Mol Genet 2001; 10 (7) 763-767
  • 6 Knudson AG. Cancer genetics. Am J Med Genet 2002; 111 (1) 96-102
  • 7 Seizinger BR, Rouleau GA, Ozelius LJ , et al. Von Hippel-Lindau disease maps to the region of chromosome 3 associated with renal cell carcinoma. Nature 1988; 332 (6161) 268-269
  • 8 Latif F, Tory K, Gnarra J , et al. Identification of the von Hippel-Lindau disease tumor suppressor gene. Science 1993; 260 (5112) 1317-1320
  • 9 Linehan WM, Lerman MI, Zbar B. Identification of the von Hippel-Lindau (VHL) gene. Its role in renal cancer. JAMA 1995; 273 (7) 564-570
  • 10 Kaelin Jr WG. Molecular basis of the VHL hereditary cancer syndrome. Nat Rev Cancer 2002; 2 (9) 673-682
  • 11 Shuin T, Yamasaki I, Tamura K, Okuda H, Furihata M, Ashida S. Von Hippel-Lindau disease: molecular pathological basis, clinical criteria, genetic testing, clinical features of tumors and treatment. Jpn J Clin Oncol 2006; 36 (6) 337-343
  • 12 Gnarra JR, Tory K, Weng Y , et al. Mutations of the VHL tumour suppressor gene in renal carcinoma. Nat Genet 1994; 7 (1) 85-90
  • 13 Kanno H, Kuratsu J, Nishikawa R , et al. Clinical features of patients bearing central nervous system hemangioblastoma in von Hippel-Lindau disease. Acta Neurochir (Wien) 2013; 155 (1) 1-7
  • 14 Melmon KL, Rosen SW. Lindau's disease. Review of the literature and study of a large kindred. Am J Med 1964; 36: 595-617
  • 15 Stolle C, Glenn G, Zbar B , et al. Improved detection of germline mutations in the von Hippel-Lindau disease tumor suppressor gene. Hum Mutat 1998; 12 (6) 417-423
  • 16 Glenn GM, Linehan WM, Hosoe S , et al. Screening for von Hippel-Lindau disease by DNA-polymorphism analysis. J Am Med Assoc 1992; 267: 1226-1231
  • 17 Nordstrom-O'Brien M, van der Luijt RB, van Rooijen E , et al. Genetic analysis of von Hippel-Lindau disease. Hum Mutat 2010; 31: 521-537
  • 18 Gossage L, Eisen T, Maher ER. VHL, the story of a tumour suppressor gene. Nat Rev Cancer 2015; 15 (1) 55-64
  • 19 Chen F, Kishida T, Yao M , et al. Germline mutations in the von Hippel-Lindau disease tumor suppressor gene: correlations with phenotype. Hum Mutat 1995; 5 (1) 66-75
  • 20 Maher ER, Webster AR, Richards FM , et al. Phenotypic expression in von Hippel- Lindau disease: Correlations with germline VHL gene mutations. J Med Genet 1996; 33: 328-332
  • 21 Crossey PA, Richards FM, Foster K , et al. Identification of intragenic mutations in the von Hippel-Lindau disease tumour suppressor gene and correlation with disease phenotype. Hum Mol Genet 1994; b: 3: 1303-1308
  • 22 Stebbins CE, Kaelin Jr WG, Pavletich NP. Structure of the VHL-ElonginC-ElonginB complex: implications for VHL tumor suppressor function. Science 1999; 284: 455-461
  • 23 Brauch H, Kishida T, Glavac D , et al. Von Hippel-Lindau (VHL) disease with pheochromocytoma in the Black Forest region of GermanyL Evidence for a founder effect. Hum Genet 1996; 95: 551-556
  • 24 Ritter MM, Frilling A, Crossey PA , et al. Isolated familial pheochromocytoma as a variant of von Hippel-Lindau disease. J Clin Endocrinol Metab 1996; 81: 1035-1037
  • 25 McNeill A, Rattenberry E, Barber R, Killick P, MacDonald F, Maher ER. Genotype-phenotype correlations in VHL exon deletions. Am J Med Genet A 2009; 149A: 2147-2151
  • 26 Maranchie JK, Afonso A, Albert PS , et al. Solid renal tumor severity in von Hippel Lindau disease is related to germline deletion length and location. Hum Mutat 2004; 23: 40-46
  • 27 Woodward ER, Eng C, McMahon R , et al. Genetic predisposition to phaeochromocytoma: analysis of candidate genes GDNF, RET and VHL. Hum Mol Genet 1997; 6 (7) 1051-1056
  • 28 Neumann HP, Bausch B, McWhinney SR , et al; Freiburg-Warsaw-Columbus Pheochromocytoma Study Group. Germ-line mutations in nonsyndromic pheochromocytoma. N Engl J Med 2002; 346 (19) 1459-1466
  • 29 Hes FJ, McKee S, Taphoorn MJ , et al. Cryptic von Hippel-Lindau disease: germline mutations in patients with haemangioblastoma only. J Med Genet 2000; b: 37: 939-943
  • 30 Maher ER, Iselius L, Yates JR , et al. Von Hippel-Lindau disease: a genetic study. J Med Genet 1991; 28 (7) 443-447
  • 31 Sgambati MT, Stolle C, Choyke PL , et al. Mosaicism in von Hippel-Lindau disease: lessons from kindreds with germline mutations identified in offspring with mosaic parents. Am J Hum Genet 2000; 66 (1) 84-91
  • 32 Richards FM, Payne SJ, Zbar B, Affara NA, Ferguson-Smith MA, Maher ER. Molecular analysis of de novo germline mutations in the von Hippel-Lindau disease gene. Hum Mol Genet 1995; 4 (11) 2139-2143
  • 33 Youssoufian H, Pyeritz RE. Mechanisms and consequences of somatic mosaicism in humans. Nat Rev Genet 2002; 3 (10) 748-758
  • 34 van der Meulen MA, van der Meulen MJ, te Meerman GJ. Recurrence risk for germinal mosaics revisited. J Med Genet 1995; 32 (2) 102-104
  • 35 Hall JG. Review and hypotheses: somatic mosaicism: observations related to clinical genetics. Am J Hum Genet 1988; 43 (4) 355-363
  • 36 Lamiell JM, Salazar FG, Hsia YE. von Hippel-Lindau disease affecting 43 members of a single kindred. Medicine (Baltimore) 1989; 68 (1) 1-29
  • 37 Louis DN, Ohgaki H, Wiestler OD, Cavenee WK , eds. WHO Classification of Tumours of the Central Nervous System. Lyon, France: IARC Press; 2007
  • 38 Niemelä M, Lemeta S, Sainio M , et al. Hemangioblastomas of the retina: impact of von Hippel-Lindau disease. Invest Ophthalmol Vis Sci 2000; 41 (7) 1909-1915
  • 39 Neumann HPH, Eggert HR, Weigel K, Friedburg H, Wiestler OD, Schollmeyer P. Hemangioblastomas of the central nervous system. A 10-year study with special reference to von Hippel-Lindau syndrome. J Neurosurg 1989; 70 (1) 24-30
  • 40 Vougioukas VI, Gläsker S, Hubbe U , et al. Surgical treatment of hemangioblastomas of the central nervous system in pediatric patients. Childs Nerv Syst 2006; 22 (9) 1149-1153
  • 41 Jung SM, Kuo TT. Immunoreactivity of CD10 and inhibin alpha in differentiating hemangioblastoma of central nervous system from metastatic clear cell renal cell carcinoma. Mod Pathol 2005; 18 (6) 788-794
  • 42 Slater A, Moore NR, Huson SM. The natural history of cerebellar hemangioblastomas in von Hippel-Lindau disease. AJNR Am J Neuroradiol 2003; 24 (8) 1570-1574
  • 43 Ammerman JM, Lonser RR, Dambrosia J, Butman JA, Oldfield EH. Long-term natural history of hemangioblastomas in patients with von Hippel-Lindau disease: implications for treatment. J Neurosurg 2006; 105 (2) 248-255
  • 44 Maher ER, Yates JRW, Harries R , et al. Clinical features and natural history of von Hippel-Lindau disease. Q J Med 1990; 77 (283) 1151-1163
  • 45 Jagannathan J, Lonser RR, Smith R, DeVroom HL, Oldfield EH. Surgical management of cerebellar hemangioblastomas in patients with von Hippel-Lindau disease. J Neurosurg 2008; 108 (2) 210-222
  • 46 Singh AD, Shields CL, Shields JA. von Hippel-Lindau disease. Surv Ophthalmol 2001; 46 (2) 117-142
  • 47 Kuo M-T, Kou H-K, Kao M-L, Tsai M-H, Chen Y-J, Lin S-A. Retinal capillary hemangiomas: clinical manifestations and visual prognosis. Chang Gung Med J 2002; 25 (10) 672-682
  • 48 Wong WT, Agrón E, Coleman HR , et al. Clinical characterization of retinal capillary hemangioblastomas in a large population of patients with von Hippel-Lindau disease. Ophthalmology 2008; 115 (1) 181-188
  • 49 Gaudric A, Krivosic V, Duguid G, Massin P, Giraud S, Richard S. Vitreoretinal surgery for severe retinal capillary hemangiomas in von hippel-lindau disease. Ophthalmology 2011; 118 (1) 142-149
  • 50 Browne TR, Adams RD, Roberson GH. Hemangioblastoma of the spinal cord. Review and report of five cases. Arch Neurol 1976; 33 (6) 435-441
  • 51 Na JH, Kim HS, Eoh W, Kim JH, Kim JS, Kim E-S. Spinal cord hemangioblastoma : diagnosis and clinical outcome after surgical treatment. J Korean Neurosurg Soc 2007; 42 (6) 436-440
  • 52 Weil RJ, Lonser RR, DeVroom HL, Wanebo JE, Oldfield EH. Surgical management of brainstem hemangioblastomas in patients with von Hippel-Lindau disease. J Neurosurg 2003; 98 (1) 95-105
  • 53 Lonser RR, Weil RJ, Wanebo JE, DeVroom HL, Oldfield EH. Surgical management of spinal cord hemangioblastomas in patients with von Hippel-Lindau disease. J Neurosurg 2003; 98 (1) 106-116
  • 54 Barrisford GW, Singer EA, Rosner IL, Linehan WM, Bratslavsky G. Familial renal cancer: molecular genetics and surgical management. Int J Surg Oncol 2011; ;2011, Article ID 658767
  • 55 Keeler III LL, Klauber GT. Von Hippel-Lindau disease and renal cell carcinoma in a 16-year-old boy. J Urol 1992; 147 (6) 1588-1591
  • 56 Paraf F, Chauveau D, Chrétien Y, Richard S, Grünfeld JP, Droz D. Renal lesions in von Hippel-Lindau disease: immunohistochemical expression of nephron differentiation molecules, adhesion molecules and apoptosis proteins. Histopathology 2000; 36 (5) 457-465
  • 57 Fuhrman SA, Lasky LC, Limas C. Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol 1982; 6 (7) 655-663
  • 58 Yang B, Autorino R, Remer EM , et al. Probe ablation as salvage therapy for renal tumors in von Hippel-Lindau patients: The Cleveland Clinic experience with 3 years follow-up. Urol Oncol 2013; 31: 686-692
  • 59 Baghai M, Thompson GB, Young Jr WF, Grant CS, Michels VV, van Heerden JA. Pheochromocytomas and paragangliomas in von Hippel-Lindau disease: a role for laparoscopic and cortical-sparing surgery. Arch Surg 2002; 137 (6) 682-688 , discussion 688–689
  • 60 Fishbein L, Merrill S, Fraker DL, Cohen DL, Nathanson KL. Inherited mutations in pheochromocytoma and paraganglioma: why all patients should be offered genetic testing. Ann Surg Oncol 2013; 20 (5) 1444-1450
  • 61 McNicol AM. Update on tumours of the adrenal cortex, phaeochromocytoma and extra-adrenal paraganglioma. Histopathology 2011; 58 (2) 155-168
  • 62 Opocher G, Conton P, Schiavi F, Macino B, Mantero F. Pheochromocytoma in von Hippel-Lindau disease and neurofibromatosis type 1. Fam Cancer 2005; 4 (1) 13-16
  • 63 Havekes B, Romijn JA, Eisenhofer G, Adams K, Pacak K. Update on pediatric pheochromocytoma. Pediatr Nephrol 2009; 24 (5) 943-950
  • 64 Neumann HP, Dinkel E, Brambs H , et al. Pancreatic lesions in the von Hippel-Lindau syndrome. Gastroenterology 1991; 101 (2) 465-471
  • 65 van Asselt SJ, de Vries EGE, van Dullemen HM , et al. Pancreatic cyst development: insights from von Hippel-Lindau disease. Cilia 2013; 2 (1) 3
  • 66 Volkan Adsay N. Cystic lesions of the pancreas. Mod Pathol 2007; 20 (Suppl. 01) S71-S93
  • 67 Blansfield JA, Choyke L, Morita SY , et al. Clinical, genetic and radiographic analysis of 108 patients with von Hippel-Lindau disease (VHL) manifested by pancreatic neuroendocrine neoplasms (PNETs). Surgery 2007; 142 (6) 814-818 , discussion 818.e1–818.e2
  • 68 Marcos HB, Libutti SK, Alexander HR , et al. Neuroendocrine tumors of the pancreas in von Hippel-Lindau disease: spectrum of appearances at CT and MR imaging with histopathologic comparison. Radiology 2002; 225 (3) 751-758
  • 69 Chen M, Van Ness M, Guo Y, Gregg J. Molecular pathology of pancreatic neuroendocrine tumors. J Gastrointest Oncol 2012; 3 (3) 182-188
  • 70 Lubensky IA, Pack S, Ault D , et al. Multiple neuroendocrine tumors of the pancreas in von Hippel-Lindau disease patients: histopathological and molecular genetic analysis. Am J Pathol 1998; 153 (1) 223-231
  • 71 Frankel WL. Update on pancreatic endocrine tumors. Arch Pathol Lab Med 2006; 130 (7) 963-966
  • 72 Asa SL. Pancreatic endocrine tumors. Mod Pathol 2011; 24 (Suppl. 02) S66-S77
  • 73 Bosman FT, Carneiro F, Hruban RH, Theise ND , eds. WHO Classification of Tumours of the Digestive System. Lyon, France: IARC Press; 2010
  • 74 Tamura K, Nishimori I, Ito T, Yamasaki I, Igarashi H, Shuin T. Diagnosis and management of pancreatic neuroendocrine tumor in von Hippel-Lindau disease. World J Gastroenterol 2010; 16 (36) 4515-4518
  • 75 Tseng JF, Warshaw AL, Sahani DV, Lauwers GY, Rattner DW, Fernandez-del Castillo C. Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment. Ann Surg 2005; 242 (3) 413-419 , discussion 419–421
  • 76 Wind JJ, Lonser RR. Management of von Hippel-Lindau disease-associated CNS lesions. Expert Rev Neurother 2011; 11 (10) 1433-1441
  • 77 Brandt R. Aur erage der angiomatosis retinae. Von Graefes Arch Ophthalmol 1921; 106: 127-136
  • 78 Lindau A. Studies on cerebellar cysts: development, pathogenesis, and relationship with retinal angiomatosis. Acta Pathol Microbiol Scand Suppl 1926; 1: 1-128
  • 79 Hassard AD, Boudreau SF, Cron CC. Adenoma of the endolymphatic sac. J Otolaryngol 1984; 13 (4) 213-216
  • 80 Heffner DK. Low-grade adenocarcinoma of probable endolymphatic sac origin A clinicopathologic study of 20 cases. Cancer 1989; 64 (11) 2292-2302
  • 81 Gläsker S, Lonser RR, Tran MG , et al. Effects of VHL deficiency on endolymphatic duct and sac. Cancer Res 2005; 65 (23) 10847-10853
  • 82 Choo D, Shotland L, Mastroianni M , et al. Endolymphatic sac tumors in von Hippel-Lindau disease. J Neurosurg 2004; 100 (3) 480-487
  • 83 Kim HJ, Hagan M, Butman JA , et al. Surgical resection of endolymphatic sac tumors in von Hippel-Lindau disease: findings, results, and indications. Laryngoscope 2013; 123 (2) 477-483
  • 84 Family Alliance VHL. The VHL Handbook: What You Need to Know about VHL. 4th ed. 2012. Available at: http://vhl.org/wordpress/library/Handbook/handbook40.pdf . Accessed July 11, 2015