First, we thank Gardi et al.1 for their recognition of the need for and support for the establishment of a Multidisciplinary Integrated Care Pathway for von Hippel-Lindau (VHL) disease, which we recently described as being generated in the context of the Dutch VHL expertise centers system.2 We agree that a VHL integrated care pathway should be implemented in designated referral centers with vast experience in VHL care, and we are not proponents of VHL care in hospitals that care for sporadic patients with VHL. Reply to "von Hippel-Lindau disease integrated care pathway: Centralizing, expanding specialists' theatre, and measuring improvement" The multidisciplinary integrated care pathway for VHL disease should be considered a starting point for optimal VHL care. [Extracted from the article]