SMAD4 and hereditary hemorrhagic telangiectasia: Suspicion for a hereditary telangiectasia syndrome but not necessarily for classic HHT (e.g., telangiectases with atypical distribution, lack of epistaxis, lack of solid organ involvement); a five gene (ENG, ACVRL1, SMAD4, RASA1, and GDF2) NGS panel (Table 1) and corresponding array comparative genomic hybridization (aCGH) for the detection of large deletions and duplications in the same five genes.