In support of this possibility, clinical cases of metastatic tumors without primary tumors have been reported for t(1;13) PAX7:FOXO1 aRMS (Lisboa et al. 2008) and t(2;13) PAX3:FOXO1 aRMS (Sandberg et al. 2001; Lisboa et al. 2008). This evidence concerns the gene FOXO1 and metastatic neoplasm.