Clinical Information

Germline variants in the VHL gene are associated with Von Hippel-Lindau (VHL) syndrome, a rare autosomal dominant hereditary cancer syndrome.(1,2) VHL syndrome is characterized by an increased risk of developing a variety of cancerous and non-cancerous tumors and lesions, including hemangioblastomas of the brain or spinal cord, retinal angiomas, renal, pancreatic and epididymal cysts, pheochromocytomas, pancreatic neuroendocrine tumors, endolymphatic cell tumors, and clear cell renal cell carcinoma.(3) While considered a highly penetrant condition, approximately 20% of VHL syndrome cases are due to new (de novo) disease-causing variants, which, in some cases, result in disease mosaicism.(4)

Research has suggested certain combinations of VHL tumors cluster in VHL families, and this may be driven by the type of VHL gene variant present in the family.(4) This observation has led to a phenotype-based classification of VHL syndrome. However, these patterns are not entirely specific and should not necessarily be used for diagnostic or therapeutic purposes.

The National Comprehensive Cancer Network provides recommendations regarding the medical management of individuals with VHL syndrome.

Of note, germline variants in the VHL gene are also associated with autosomal recessive hereditary erythrocytosis or polycythemia. Cases of VHL cancer syndrome and erythrocytosis are largely mutually exclusive, although there is some overlap. For information regarding genetic testing for patients suspected to have hereditary erythrocytosis or polycythemia, see HEMP / Hereditary Erythrocytosis Mutations, Whole Blood.