Renal cancer genetics: von Hippel Lindau and other syndromes.

There have been significant advances in our understanding of the genetic basis of renal carcinogenesis. In particular, research in the last five years has demonstrated a central role for the inactivation of the von Hippel-Lindau gene by mutation or hypermethylation in the formation of the conventional type of renal cell carcinoma. The von Hippel-Lindau syndrome is characterised by germ-line inactivating mutation whereas sporadic renal carcinoma is associated with somatic mutations. Tumour formation is accompanied by loss of the remaining wild-type allele. The biology of the von Hippel-Lindau gene and its normal function continued to be unravelled but a role has been demonstrated for it in the regulation of gene transcription, the regulation of oxygen-dependent genes and their expression and the control of tumour angiogenesis acting via the vascular endothelial growth factor. Another form of familial renal cancer, the hereditary papillary renal cell carcinoma, has been shown to be consequent upon activating mutations of the c-met proto-oncogene. The genetic data continue to enhance our understanding of the biology of this common set of neoplasms.