Several genes had variants in both FCCTX-like and Lynch-like cases including all MMR genes (MLH1, MSH2, MSH6, and MSH3), HELQ, POLQ, LRIG1, PTCH1, LAMA2, and NOS1. Some MMR variants found in FCCTX-like MSS cases may still be pathogenic, since MMR mutations have been reported in MSS CRC patients, especially those with MSH6 mutations. The gene discussed is HELQ; the disease is Marinesco-Sjogren syndrome.