PTEN and PTEN hamartoma tumor syndrome: The Cleveland Clinic score, a quantitative surrogate of age-related PHTS disease burden,16 ranged from 0 to 69 (mean [SD], 20 [13]), corroborating the broad phenotypic spectrum, including participants with unexpectedly mild disease manifestations (eg, absence of early-onset component cancers and neurotypical development) despite their underlying pathogenic germline PTEN mutations.