PatientID: None

KindredID: 1

Case: M, 40Y0M, Caucasian

DiseaseAssertion: VHL

FamilyInfo: The patient’s father died of renal cell carcinoma at the age of 49, his brother had a spinal hemangioblastoma which was removed at 19 years of age (he was confirmed with this germline mutation) and he had a son who was asymptomatic but was confirmed with this germline mutation. The patient's mother had uterine cancer, the paternal grandmother died at age 92 years of pancreatic cancer, a paternal grandfather died at age 52 years from lung cancer, and the paternal grandfather’s nephew had been diagnosed with a brain tumor. Refer to pedigree at Figure 3.

CasePresentingHPOs: HP:0000822, HP:0005584, HP:0009715, HP:0000107, HP:0001737 (Hypertension, renal cell carcinoma, papillary cystadenoma of the epididymis, renal cyst, pancreatic cysts)

CaseHPOFreeText: His past medical history was significant only for hypertension for three years for which he took atenolol and terazosin. Renal angiography demonstrated multiple vascular lesions involving both kidneys with an angiographic pattern consistent with malignancy. Renal pathology revealed multiple foci of renal cell carcinoma with nine tumors in the right kidney and evidence of micrometastases. The adjacent parenchyma was filled with multiple, dilated cysts. There was evidence of tumor extension into the proximal renal veins and the perinephric fatty tissue.The pathologic findings of the left kidney were similar to the right kidney and demonstrated multiple foci of renal cell carcinoma. In addition, the patient underwent scrotal exploration and local excision of a complex epididymal mass, which was found to be a clear cell papillary cystadenoma.

CaseNotHPOs: N/A

CaseNotHPOFreeText: Magnetic resonance imaging of the brain and spinal cord, and a thorough ophthalmologic examination were performed; all of which were normal.

CasePreviousTesting: N/A

PreviouslyPublished: N/A

SupplementalData: N/A

Variant: p.P86L (c.257C>T)

CaseProblemVariantFreeText: N/A

LegacyVariant: p.P86L (c.470C>T)

ClinVarID: 182977 https://www.ncbi.nlm.nih.gov/clinvar/variation/182977/

CAID: N/A

gnomAD: N/A

VariantEvidence: N/A

MutationType: missense_variant; transition

CivicName: P86L (c.257C>T)

MultipleGeneVariants: N/A

PatientID: 12

KindredID: 12

Case: Sex Unknown, 42Y0M, Chinese

DiseaseAssertion: VHL

FamilyInfo: Patient had no family history of VHL disease.

CohortInfo: 16 Chinese patients clinically diagnosed with VHL disease.

CasePresentingHPOs: HP:0010797; HP:0005584; HP:0001732 (hemangioblastoma; renal cell carcinoma; abnormality of the pancreas)

CaseHPOFreeText: The patient presented with a hemangioblastoma at age 36 and then renal cell carcinoma and multiple pancreatic cysts or tumors at age 40.

CaseNotHPOs: HP:0009711, HP:0002666, HP:0030393, HP:0030424 (retinal capillary hemangioma, pheochromocytoma, endolymphatic sac tumor, epididymal cyst)

CaseNotHPOFreeText: N/A

CasePreviousTesting: N/A

PreviouslyPublished: N/A

SupplementalData: N/A

Variant: p.F76del (c.227-229delTCT)

LegacyVariant: N/A

CaseProblemVariantFreeText: N/A

ClinVarID: N/A

CAID: CA357012, https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.224_226delTCT

gnomAD: N/A

VariantEvidence: N/A

MutationType: minus_1_frameshift_variant

CivicName: F76del (c.224_226delTCT)

MultipleGeneVariants: N/A

PatientID: 27

KindredID: 9

Case: F, 40Y0M, Chinese

DiseaseAssertion: VHL

FamilyInfo: N/A

CasePresentingHPOs: HP:0001737; HP:0001732; HP:0005584; HP:0010797 (Pancreatic cysts, Abnormality of the pancreas, Renal cell carcinoma, Hemangioblastoma)

CaseHPOFreeText: The proband, patient 27, presented at age 36 with a CNS hemangioblastoma, and renal cell carcinoma and multiple pancreatic cysts and tumors at 40.

CaseNotHPOs: HP:0002666, HP:0009711 (Pheochromocytoma, Retinal capillary hemangioma)

CaseNotHPOFreeText: N/A

CasePreviousTesting: N/A

PreviouslyPublished: This patient was also published in a later paper by Wang et al., 2018 (PMID: 29330336). This mutation was also published in PMID 32179488 in reference to one patient with VHL disease type 1 in this paper with the c.227_229del variant. However, it is unclear whether patient #27, #28, or #30 is specifically published in PMID 32179488.

SupplementalData: Patient and family genotype-phenotype information is listed in Supplementary Table 1.

Variant: p.F76del (c.227_229del)

LegacyVariant: N/A

CaseProblemVariantFreeText: N/A

ClinVarID: N/A

CAID: CA357012; https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.224_226del

gnomAD: N/A

VariantEvidence: N/A

MutationType: inframe_deletion

CivicName: F76del (c.224_226delTCT)

MultipleGeneVariants: N/A

PatientID: 12

KindredID: 1 (group ID 5)

Case: M, 40Y0M (deceased), Chinese

DiseaseAssertion: assumed VHL

CohortInfo: Clinical characteristics of 258 patients from 80 unrelated Chinese families were reported in this study. Grouped by the 21 mutations found, 2 families with 21 members total were described, and phenotypic information was given for this group.

FamilyInfo: In family 1, 17 members were described. The first generation describes 5 members with the VHL mutation, each passing on the gene to further generations. Patient 12’s mother and brother had this familial mutation. His two daughters had not been yet tested at the time of the study. See Fig 4 for family pedigree; Table 3 for details.

CasePresentingHPOs: HP:0005584 (renal cell carcinoma)

CaseHPOFreeText: He had RCC at 40Y

CaseNotHPOs: N/A

CaseNotHPOFreeText: N/A

CasePreviousTesting: N/A

PreviouslyPublished: N/A

SupplementalData: N/A

Variant: p.W88R (c.262T>C)

LegacyVariant: N/A

CaseProblemVariantFreeText: N/A

ClinVarID: 496053 https://www.ncbi.nlm.nih.gov/clinvar/variation/496053/

CAID: N/A

gnomAD: N/A

VariantEvidence: N/A

MutationType: missense_variant;transition

CivicName: W88R (c.262T>C)

MultipleGeneVariants: N/A