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Li Y, Xin X, Song W, Zhang X, Chen S, Wang Q, Li A, Li Y. VHL syndrome without clear family history: A rare case report and literature review of Chinese patients. Front Neurol 2022; 13:951054. [PMID: 36324386 PMCID: PMC9618664 DOI: 10.3389/fneur.2022.951054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/05/2022] [Indexed: 11/26/2022] Open
Abstract
Objective To analyze the clinical manifestations and imaging features of a hospitalized patient with intermittent headache who was finally diagnosed with von Hippel–Lindau (VHL) syndrome and to perform whole-exon gene detection to improve the understanding of the diagnosis and treatment strategies of the disease. Methods A case of suspected VHL syndrome in Shanxi Provincial People's Hospital was analyzed. Proband DNA was also extracted for whole exome sequencing and screened for causative mutation sites, which were validated by Sanger sequencing. The literature about VHL gene mutations in Chinese patients in the past 10 years were also reviewed. Results There is a heterozygous mutation site c.499C > G on the VHL gene on the short arm of chromosome 3 of the patient, which is a missense mutation. The mutation results in the substitution of arginine with glycine at amino acid 167 of the encoded protein, which may be primarily responsible for the disease in the patient with VHL syndrome. However, the mutation did not occur in other family members. Conclusion Early recognition and treatment of VHL syndrome can be available with genetic testing technology. Strengthening the understanding of this complex genetic disease and improving the diagnostic rate of VHL syndrome are helpful for the precise treatment of patients with this disease, which may help prolong the survival time of patients to a certain extent and improve their quality of life.
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Affiliation(s)
- Yaheng Li
- Department of Nephrology, Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, China
- Shanxi Provincial Key Laboratory of Kidney Disease, Taiyuan, China
| | - Xiaohong Xin
- Core Laboratory, Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi University, Taiyuan, China
- Academy of Microbial Ecology, Shanxi Medical University, Taiyuan, China
| | - Wenzhu Song
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xuan Zhang
- Department of Neurosurgery, Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, China
| | - Shengli Chen
- Department of Neurosurgery, Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, China
| | - Qian Wang
- Department of Nephrology, Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, China
- Shanxi Provincial Key Laboratory of Kidney Disease, Taiyuan, China
| | - Aizhong Li
- Department of Nephrology, Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, China
- Shanxi Provincial Key Laboratory of Kidney Disease, Taiyuan, China
| | - Yafeng Li
- Department of Nephrology, Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi Medical University, Taiyuan, China
- Shanxi Provincial Key Laboratory of Kidney Disease, Taiyuan, China
- Core Laboratory, Shanxi Provincial People's Hospital (Fifth Hospital) of Shanxi University, Taiyuan, China
- Academy of Microbial Ecology, Shanxi Medical University, Taiyuan, China
- *Correspondence: Yafeng Li
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Liu P, Zhu F, Li M, Dube DA, Liu Q, Wang C, Xiao Q, Zhang L, Gao S, Li Z, Zhang B, Liu J, Liu L, Chen X. Von Hippel-Lindau "Black Forest" mutation inherited in a large Chinese family. Gland Surg 2019; 8:343-353. [PMID: 31538058 DOI: 10.21037/gs.2019.08.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background The Von Hippel-Lindau (VHL) p.Tyr98His (Y98H) mutation is designated as the "Black Forest" founder mutation and has been previously reported in Western countries. This study reports the first recorded Chinese VHL family with the "Black Forest" mutation in Asia. Methods Paired whole-exome sequencing (WES), Sanger sequencing and immunohistochemistry (IHC) were performed on samples from a large Chinese family to confirm the causative mutation and mutation carriers in the family. Clinical manifestations of the family were summarized and compared with those reported from other patients with the VHL Y98H mutation. Results The Chinese pheochromocytoma (PCC) family was identified as a VHL type 2 family with a Y98H mutation. There were 4 VHL patients and 11 currently healthy individuals with the mutation. Copy number analysis and SDHB IHC were performed to exclude interference from other pathogenic genes of PCC or paraganglioma (PGL). Conclusions We report the first recorded instance of a Chinese VHL type 2 family with the "Black Forest" mutation by using WES and Sanger sequencing, which widens the currently recorded presence of the "Black Forest" mutation to China and potentially elsewhere in Asia and indicates that the "Black Forest" mutation does not uniquely evolve in occidental countries. A personalized surveillance approach, which may be more appropriate for affected families, has been recommended to improve quality of life.
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Affiliation(s)
- Peihua Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Feizhou Zhu
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China.,Department of Biochemistry and Molecular Biology, School of Life Sciences, Central South University, Changsha 410013, China
| | - Minghao Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Daud Athanasius Dube
- Academic Training Unit of Urological Surgery, College of Health Science, University of Zimbabwe, Harare, Zimbabwe
| | - Qianqian Liu
- Department of Biochemistry and Molecular Biology, School of Life Sciences, Central South University, Changsha 410013, China
| | - Cikui Wang
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Qiao Xiao
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Liang Zhang
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Shuai Gao
- Department of Biochemistry and Molecular Biology, School of Life Sciences, Central South University, Changsha 410013, China
| | - Zhuolin Li
- Department of Biochemistry and Molecular Biology, School of Life Sciences, Central South University, Changsha 410013, China
| | - Bo Zhang
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Jing Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Longfei Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xiang Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
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Tirosh A, el Lakis M, Green P, Nockel P, Patel D, Nilubol N, Gara SK, Keutgen XM, Linehan WM, Kebebew E. In silico VHL Gene Mutation Analysis and Prognosis of Pancreatic Neuroendocrine Tumors in von Hippel-Lindau Disease. J Clin Endocrinol Metab 2018; 103:1631-1638. [PMID: 29294023 PMCID: PMC6276699 DOI: 10.1210/jc.2017-02434] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 12/20/2017] [Indexed: 02/06/2023]
Abstract
Context Patients with von Hippel-Lindau (vHL) disease caused by a missense VHL mutation have a more severe phenotype compared with other VHL mutation types. Objective To define pancreatic neuroendocrine tumor (PNET) aggressiveness according to VHL genotype. Design A prospective natural history study. Setting The National Institutes of Health clinical center. Patients Patients with vHL disease, pancreatic manifestations, and germline missense VHL gene mutations. Intervention In-silico prediction of VHL mutation via five computational prediction models. Patients with >80% prediction for disease-causing mutations in all models [high predicted risk (HPR)] were compared with others [low predicted risk (LPR)]. Main Outcome Measure Rates of metastases, surgical intervention, and disease progression. Results Sixty-nine patients were included: 2 developed metastases, 12 needed surgery, and 31 had disease progression during a median follow-up of 60 months (range 13 to 84 months). Thirteen patients were excluded for low prediction reliability. In the remaining 56 patients (45 with PNETs, 11 with pancreatic cysts), the HPR group (n = 13) had a higher rate of disease progression than the LPR group (n = 43) in multivariable analysis (hazard ratio 3.6; 95% confidence interval, 1.1 to 11.9; P = 0.037). The HPR group also had a higher risk of developing metastases (P = 0.015). Among patients with codon 167 hotspot mutations (n = 26), those in the HPR group had a higher risk for disease progression (P = 0.03) than other patients. Conclusions Computational models for predicting the impact of missense VHL gene mutations may be used as a prognostic factor in patients with PNETs in the context of vHL disease.
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Affiliation(s)
- Amit Tirosh
- Endocrine Oncology Branch, National Cancer Institute, National Institutes of
Health, Bethesda, Maryland
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mustapha el Lakis
- Endocrine Oncology Branch, National Cancer Institute, National Institutes of
Health, Bethesda, Maryland
| | - Patience Green
- Endocrine Oncology Branch, National Cancer Institute, National Institutes of
Health, Bethesda, Maryland
| | - Pavel Nockel
- Endocrine Oncology Branch, National Cancer Institute, National Institutes of
Health, Bethesda, Maryland
| | - Dhaval Patel
- Endocrine Oncology Branch, National Cancer Institute, National Institutes of
Health, Bethesda, Maryland
| | - Naris Nilubol
- Endocrine Oncology Branch, National Cancer Institute, National Institutes of
Health, Bethesda, Maryland
| | - Sudheer Kumar Gara
- Endocrine Oncology Branch, National Cancer Institute, National Institutes of
Health, Bethesda, Maryland
| | - Xavier M Keutgen
- Endocrine Oncology Branch, National Cancer Institute, National Institutes of
Health, Bethesda, Maryland
- Department of Surgery, Division of Surgical Oncology, Rush University Medical
Center, Chicago, Illinois
| | - W Marston Linehan
- Urologic Oncology Branch, National Cancer Institute, National Institutes of
Health, Bethesda, Maryland
| | - Electron Kebebew
- Endocrine Oncology Branch, National Cancer Institute, National Institutes of
Health, Bethesda, Maryland
- Department of Surgery, The George Washington University, School of Medicine and
Health Sciences, Washington, District of Columbia
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Abdel-Rahman O. Risk of Subsequent Primary Kidney Cancer After Another Malignancy: A Population-based Study. Clin Genitourin Cancer 2017; 15:e747-e754. [PMID: 28314541 DOI: 10.1016/j.clgc.2017.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 02/13/2017] [Accepted: 02/19/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Population-based data on the development of kidney cancer as a second malignant neoplasm following the diagnosis of other common malignancies are rare. This clinical scenario has been evaluated within the Surveillance, Epidemiology, and End Results (SEER) database. MATERIALS AND METHODS The SEER-9 database (1973-2013) was queried using the SEER*Stat program to determine the standardized incidence ratios (SIRs) of kidney cancer development following each one of 10 common invasive malignancies (colorectal, breast, prostate, lung, thyroid, corpus uteri, urinary bladder, kidney/renal pelvis, cutaneous melanoma, and non-Hodgkin lymphoma). The following data were collected for patients with a second renal cancer: age at diagnosis of the second renal cancer; gender, race, and histology of the second primary renal cancer; SEER historic stage of the second primary renal cancer; and method of diagnostic confirmation of the second primary cancer. RESULTS A total of 10,145 kidney cancers were observed. Elevated SIRs for kidney cancer were noted for all 10 evaluated malignancies in the initial 12 months after diagnosis. The SIRs remained elevated 12 to 59 months after diagnosis for all cancers except breast and prostate cancers. Increased risks persisted 60 to 119 months beyond diagnosis for renal cancer (SIR, 4.13), thyroid cancer (SIR, 2.30), and non-Hodgkin lymphoma (SIR, 1.40); and 120+ months for renal cancer (SIR, 3.60), thyroid cancer (SIR, 1.90), and non-Hodgkin lymphoma (SIR, 1.27). Increased kidney cancer risk after non-Hodgkin lymphoma was not related to radiation therapy. Papillary renal cell carcinoma has the highest SIRs for subsequent kidney cancers. CONCLUSION Many common cancers are associated with an increased risk of kidney cancer development within the first 5 years after their diagnosis. Although this can be partly interpreted by increased rates of surveillance tests, radiotherapy effects, or genetic associations for some cancers, additional research is required to explain the persistently increased risk beyond 5 years associated with some cancers.
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Affiliation(s)
- Omar Abdel-Rahman
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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