In contrast, the risk of biological aggression in sporadic disease (especially in pheochromocytoma) has been linked to a novel molecular pathway known as the wnt-altered pathway characterized by MAML3 (Mastermind Like Transcriptional Coactivator 3) oncogene fusions along with other alterations including ATRX (Alpha Thalassemia/Mental Retardation Syndrome X-Linked) and CSDE1 (Cold Shock Domain Containing E1) mutations [66]. This evidence concerns the gene MAML3 and hereditary pheochromocytoma-paraganglioma.