VHL and cancer: Fifteen somatically mutated genes in all 4 cases are in the Cancer Gene Consensus, including TP53, NF2, KRAS, and IKZF. However, none of the top mutated genes identified in ccRCC, including VHL, PBRM1, SETD2, KDM5C, BAP1, PTEN, MTOR, and PIK3CA, were found to be altered in our study, which could be due to either the small sample size or the unique mutation spectrum of our samples.