Tumor NGS demonstrated mutations that were consistent with a previously suspected but unconfirmed cancer predisposition syndrome in four cases (NF1, neurofibromatosis type 2, Von Hippel Lindau syndrome, and Gorlin syndrome), confirmed CMMRD in one patient previously thought to have NF1 and helped exclude Carney complex, tuberous sclerosis complex, and NF1 in three cases. Here, NF1 is linked to von Hippel-Lindau disease.