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Renal cancer in von Hippel-Lindau disease and related syndromes.
[von hippel-lindau disease]
Sporadic
and
hereditary
forms
of
renal
cell
carcinoma
(
RCC
)
,
von
Hippel-
Lindau
(
VHL
)
disease
and
the
familial
paraganglioma
syndromes
are
closely
related
in
terms
of
their
clinical
,
molecular
,
and
genetic
aspects
.
Most
RCCs
occur
sporadically
and
the
heritable
fraction
of
RCC
is
estimated
to
be
just
2
-
4
%
.
An
understanding
of
the
molecular
genetic
basis
,
the
disease-
specific
and
gene
-
specific
biology
and
the
clinical
characteristics
of
these
cancer
syndromes
is
of
utmost
importance
for
effective
genetic
diagnosis
and
appropriate
treatment
.
In
addition
,
such
insight
will
improve
our
understanding
of
sporadic
RCCs
.
To
date
,
10
different
heritable
RCC
syndromes
have
been
described
.
VHL
syndrome
is
the
oldest
known
hereditary
RCC
syndrome
.
Similar
to
VHL
disease
,
phaeochromocytoma
is
a
major
manifestation
of
the
paraganglioma
syndromes
types
1
,
3
and
4
in
which
RCCs
have
been
reported
.
These
syndromes
are
therefore
regarded
as
VHL
-related
disorders
and
are
included
in
this
Review
.
Multifocal
tumours
,
bilateral
occurrence
,
a
young
age
at
diagnosis
and
/
or
family
history
are
clinical
red
flags
suggestive
of
hereditary
disease
and
should
trigger
referral
for
genetic
and
molecular
analysis
.
The
identification
of
an
underlying
genetic
alteration
enables
gene
-
specific
risk
assessment
and
opens
up
the
possibility
of
a
tailored
follow-up
strategy
and
specific
surveillance
protocols
as
the
basis
of
effective
preventive
medicine
.
The
important
goals
of
preventive
medicine
are
to
increase
the
life
expectancy
of
affected
patients
and
to
improve
their
quality
of
life
.
The
study
of
seemingly
rare
hereditary
syndromes
and
their
susceptibility
genes
has
consistently
revealed
clues
regarding
the
aetiology
and
pathogenesis
of
these
diseases
,
and
can
aid
diagnosis
and
the
development
of
therapeutics
for
patients
affected
by
much
more
common
sporadic
counterparts
.
Diseases
Validation
Diseases presenting
"clinical red flags"
symptom
von hippel-lindau disease
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