Expert: Claes-Gustaf Nordquist, M.D. - 2/3/2008

Question
QUESTION: Hello, my father had a hemangioblastoma in his cerebellum(no VHL) removed in 2006.  MRI was negative in Sept 2007.  In Janurary 2008, the doctor said there were what looked to by cysts in the tumor removal site.  He is a diabetic and has stage 4 chronic kidney disease and are currently checking for prostate cancer.  What could these cysts be? secondary tumor developing?  Any info would be appreciated.  Thank you

ANSWER: So he has been operated for what is called a Lindau tumor (hemangioblastoma of the cerebellum). You say that he does not have a von Hippel-Lindau disease (VHL) but at the same time you inform me that he has some chronic kidney problem. Both Lindau tumors and kidney problems are common in VHL. So I'm a bit confused here. I can not rule out that these cysts now seen indicate a relapse of his tumor. You should discuss that with his dr. The risk of a relapse increases if a case IS a VHL-case! So again any presence of a relapse would make a VHL-case more probable! Again you should discuss this with his dr., especially as 25% or so of VHL-cases have a genetic cause and if that should be the case here you may be at risk of developing this kind of illness. Please do keep me posted! Good luck!


---------- FOLLOW-UP ----------

QUESTION: Thank you for your timely response.  I neglected, apologetically, to inform you that the stage 4 chronic kidney disease is caused by diabetes.  (type 1) He is on a sodium free diet and is quite diligent in following is diet.  His sugar in quite good, but unfortunately his blood on average is too high.  I am hoping this additional information will aide in clarification. If cancer is present, can these cysts be a secondary tumor?

Answer
Ok, good so we can leave the thoughts on VHL aside! Even so I can not exclude the possibility of a relapse of his hemangioblastoma in his cerebellum and that that is what has been seen! You must discuss this with his drs. as they are the only ones who can bring this - hopefully - to a confirmation or an exclusion. Ok?