Although a report of a possible genotype–phenotype correlation of follicular carcinoma with C-terminal WRN mutations and papillary carcinoma with WRN-N-terminal mutations among Japanese WS patients has been published [14], in general the clinical phenotypes and natural history of WS patients appear to be very similar among WRN mutation types and different ethnic groups [11]. This evidence concerns the gene WRN and papillary carcinoma.