Consistent with previous reports [16, 17], the genetic compositions among the four patients were diverse (Figure 2), with alterations in genes known to be recurrently mutated in ccRCC, i.e. VHL, SETD2, PBRM1, and BAP1 [14, 15] and others which are known oncogenes or might be potential therapy targets. Here, PBRM1 is linked to nonpapillary renal cell carcinoma.