Furness, H;
Salfity, L;
Devereux, J;
Halliday, D;
Hanson, H;
Ruddy, DM;
Uk Vhl Study Group, ;
Shah, N;
Sultana, G;
Woodward, ER;
et al.
Furness, H; Salfity, L; Devereux, J; Halliday, D; Hanson, H; Ruddy, DM; Uk Vhl Study Group; Shah, N; Sultana, G; Woodward, ER; Sandford, RN; Snape, KM; Maher, ER
(2021)
Investigation and Management of Apparently Sporadic Central Nervous System Haemangioblastoma for Evidence of Von Hippel-Lindau Disease.
Genes (Basel), 12 (9).
p. 1414.
ISSN 2073-4425
https://doi.org/10.3390/genes12091414
SGUL Authors: Snape, Katie Mairwen Greenwood
Abstract
Haemangioblastomas are rare, highly vascularised tumours that typically occur in the cerebellum, brain stem and spinal cord. Up to a third of individuals with a haemangioblastoma will have von Hippel-Lindau (VHL) disease. Individuals with haemangioblastoma and underlying VHL disease present, on average, at a younger age and frequently have a personal or family history of VHL disease-related tumours (e.g., retinal or central nervous system (CNS) haemangioblastomas, renal cell carcinoma, phaeochromocytoma). However, a subset present an apparently sporadic haemangioblastoma without other features of VHL disease. To detect such individuals, it has been recommended that genetic testing and clinical/radiological assessment for VHL disease should be offered to patients with a haemangioblastoma. To assess "real-world" clinical practice, we undertook a national survey of clinical genetics centres. All participating centres responded that they would offer genetic testing and a comprehensive assessment (ophthalmological examination and CNS and abdominal imaging) to a patient presenting with a CNS haemangioblastoma. However, for individuals who tested negative, there was variability in practice with regard to the need for continued follow-up. We then reviewed the results of follow-up surveillance in 91 such individuals seen at four centres. The risk of developing a potential VHL-related tumour (haemangioblastoma or RCC) was estimated at 10.8% at 10 years follow-up. The risks of developing a recurrent haemangioblastoma were higher in those who presented <40 years of age. In the light of these and previous findings, we propose an age-stratified protocol for surveillance of VHL-related tumours in individuals with apparently isolated haemangioblastoma.
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