Genomic alterations identified include BRIP1 S988 fs: AKT1 E17K: mTOR E1799K: APC R1450: CREBBP S889: FAM123B R358: GNAS R201C: TP53 P177L and 4213Q. No reported alterations in KRAS, NRAS, and BRAF. Lynch syndrome screen by IHC (MLH1, MSH2, MSH6 and PMS2 proteins) was normal on the pathological tissue. The gene discussed is MSH2; the disease is Lynch syndrome.