Hemangioblastomas of central nervous system: Molecular genetic analysis and clinical management

Domenico Catapano, Lucia Anna Muscarella, Vito Guarnieri, Leopolde Zelante, Vincenzo Antonio D'Angelo, Leonardo D'Agruma

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Hemangioblastomas of the central nervous system (CNS) are benign neoplasms that may occur sporadically or in association with von Hippel-Lindau (VHL) disease. The proportion of primary symptomatic hemangioblastomas associated with VHL disease is estimated to be from 10 to 40%, but it seems to be underestimated. We investigated the frequency of VHL germline mutation in patients with symptomatic CNS hemangioblastoma without evidence of VHL disease to define the role of molecular genetic analysis in the management of such patients and their relatives. METHODS: We analyzed 14 patients (6 female and 8 male; mean age, 43.5 yr) with no family history and no other clinical manifestations of VHL disease who had been operated on for symptomatic CNS hemangioblastoma. Exons 1, 2, and 3 of the VHL gene and their immediately flanking sequences were amplified by use of polymerase chain reaction followed by analysis with denaturing high-performance liquid chromatography and sequencing the anomalous samples. RESULTS: Germline mutations of the VHL gene were identified in 2 (14%) of 14 patients. VHL gene mutation analysis was performed in both patients' family members, which showed another affected asymptomatic subject for VHL disease. The affected subjects were recommended for VHL disease surveillance protocol. CONCLUSION: Molecular genetic analysis is a safer and more specific instrument to confirm or exclude VHL disease in patients with CNS hemangioblastoma, a negative family history, or absence of other known manifestations of the disease. Early identification of VHL mutation gene carriers is important for reducing disease morbidity and mortality. Nonsymptomatic family members will benefit from early VHL disease diagnosis or by being excluded as at-risk subjects, reducing the psychological and economic burden of screening and surveillance protocols.

Original languageEnglish
Pages (from-to)1215-1221
Number of pages7
JournalNeurosurgery
Volume56
Issue number6
DOIs
Publication statusPublished - Jun 2005

Fingerprint

Hemangioblastoma
von Hippel-Lindau Disease
Molecular Biology
Central Nervous System
Germ-Line Mutation
Genes
Central Nervous System Neoplasms
Mutation
Exons
High Pressure Liquid Chromatography
Economics
Psychology
Morbidity
Polymerase Chain Reaction
Mortality

Keywords

  • Germline mutation
  • Hemangioblastoma
  • VHL gene
  • Von Hippel-Lindau disease

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Hemangioblastomas of central nervous system : Molecular genetic analysis and clinical management. / Catapano, Domenico; Muscarella, Lucia Anna; Guarnieri, Vito; Zelante, Leopolde; D'Angelo, Vincenzo Antonio; D'Agruma, Leonardo.

In: Neurosurgery, Vol. 56, No. 6, 06.2005, p. 1215-1221.

Research output: Contribution to journalArticle

Catapano, Domenico ; Muscarella, Lucia Anna ; Guarnieri, Vito ; Zelante, Leopolde ; D'Angelo, Vincenzo Antonio ; D'Agruma, Leonardo. / Hemangioblastomas of central nervous system : Molecular genetic analysis and clinical management. In: Neurosurgery. 2005 ; Vol. 56, No. 6. pp. 1215-1221.
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abstract = "OBJECTIVE: Hemangioblastomas of the central nervous system (CNS) are benign neoplasms that may occur sporadically or in association with von Hippel-Lindau (VHL) disease. The proportion of primary symptomatic hemangioblastomas associated with VHL disease is estimated to be from 10 to 40{\%}, but it seems to be underestimated. We investigated the frequency of VHL germline mutation in patients with symptomatic CNS hemangioblastoma without evidence of VHL disease to define the role of molecular genetic analysis in the management of such patients and their relatives. METHODS: We analyzed 14 patients (6 female and 8 male; mean age, 43.5 yr) with no family history and no other clinical manifestations of VHL disease who had been operated on for symptomatic CNS hemangioblastoma. Exons 1, 2, and 3 of the VHL gene and their immediately flanking sequences were amplified by use of polymerase chain reaction followed by analysis with denaturing high-performance liquid chromatography and sequencing the anomalous samples. RESULTS: Germline mutations of the VHL gene were identified in 2 (14{\%}) of 14 patients. VHL gene mutation analysis was performed in both patients' family members, which showed another affected asymptomatic subject for VHL disease. The affected subjects were recommended for VHL disease surveillance protocol. CONCLUSION: Molecular genetic analysis is a safer and more specific instrument to confirm or exclude VHL disease in patients with CNS hemangioblastoma, a negative family history, or absence of other known manifestations of the disease. Early identification of VHL mutation gene carriers is important for reducing disease morbidity and mortality. Nonsymptomatic family members will benefit from early VHL disease diagnosis or by being excluded as at-risk subjects, reducing the psychological and economic burden of screening and surveillance protocols.",
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