MAX and cancer: The European-American-Asian Pheochromocytoma-Paraganglioma Registry prospectively followed up on predominantly adult patients with the newer gene mutations SDHA, TMEM127, MAX, and SDHAF2 and determined that 12% (4/34) of SDHA mutation carriers and 10% (3/29) of TMEM127 mutation carriers had malignant tumors (35).