The overview of medical management options provided is a summary of professional society guidelines. The most recent version of each guideline should be consulted for more detailed and up-to-date information before developing a treatment plan for a particular patient.
This overview is provided for informational purposes only and does not constitute a recommendation. While the medical society guidelines summarized herein provide important and useful information, medical management decisions for any particular patient should be made in consultation between that patient and his or her healthcare provider and may differ from society guidelines based on a complete understanding of the patient’s personal medical history, surgeries and other treatments.
The following information for Family Members will appear as part of the MMT for a patient found to have a mutation in the VHL gene.
This patient's relatives are at risk for carrying the same mutation(s) and associated cancer risks as this patient. Cancer risks for females and males who have this/these mutation(s) are provided below.
Family members should talk to a healthcare provider about genetic testing. Close relatives such as parents, children, brothers and sisters have the highest chance of having the same mutation(s) as this patient. Other more distant relatives such as cousins, aunts, uncles, and grandparents also have a chance of carrying the same mutation(s). Testing of at-risk relatives can identify those family members with the same mutation(s) who may benefit from surveillance and early intervention.
Approximately 20% of individuals with VHL have not inherited the VHL mutation from a parent. In these cases, the mutation has developed spontaneously in that individual (a de novo mutation). Once this occurs, the children of that individual are each at 50% risk of inheriting that mutation.3
It is appropriate to offer genetic counseling to individuals with VHL who are of reproductive age to discuss reproductive risks and options. There are additional considerations during pregnancy for women with VHL.3, 6
Since VHL mutations carry a risk for complications in children and some screenings are recommended to begin in infancy, mutation testing should occur as soon as a diagnosis of VHL is suspected.4
In rare instances, an individual may inherit certain types of mutations in both copies of the VHL gene, leading to the condition familial erythrocytosis type 2, also known as VHL-related congenital erythrocytosis. Individuals with this condition have an abnormally high level of red blood cells, leading to a high risk for blood clots, strokes and other life-threatening medical problems. The children of this patient are at risk of inheriting this condition only if the other parent is also a carrier of a VHL mutation. Screening the other biological parent of any children for VHL mutations may be appropriate, even if they do not have a diagnosis of VHL.3