AUTHOR=He Shuai , Wang Cong , Yang Jing , Shen Juan , Zeng Xiaozhu , Zheng Jun , Wang Yongquan TITLE=Case report: Von Hippel-Lindau syndrome with multisystem involvement: a therapeutic dilemma JOURNAL=Frontiers in Oncology VOLUME=Volume 15 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1633911 DOI=10.3389/fonc.2025.1633911 ISSN=2234-943X ABSTRACT=We present a rare case of von Hippel-Lindau (VHL) syndrome type 2B, characterized by multisystem involvement including Stanford type B aortic dissection, pheochromocytoma, renal cell carcinoma (RCC), cerebellar hemangioblastoma with obstructive hydrocephalus, and extensive visceral cysts. This case highlights critical therapeutic dilemmas: urgent aortic repair versus risks of catecholamine surge from pheochromocytoma resection, and neurosurgical hazards of cerebellar lesions. We describe the diagnostic and therapeutic challenges associated with VHL syndrome, culminating in the development of a preliminary treatment strategy following multidisciplinary team (MDT) discussions. This study underscores the critical importance of early recognition and systematic MDT management to optimize clinical outcomes in VHL syndrome.