The latter study documented MAX germline mutations in 23 nonrelated patients, all with adrenal tumors; among the 19 patients considered for phenotypic associations, 13 (68%) presented with bilateral or multifocal pheochromocytoma and 16% developed additional thoracoabdominal paragangliomas [131]. The gene discussed is MAX; the disease is hereditary pheochromocytoma-paraganglioma.