In a fifth patient with 3 different MBM, NRAS and TP53 mutations were found in all 3 tumors, while 2 tumors harbored mutations in 5 other genes (ERBB2, ERBB4, KDR, PDGFRA, PTPN11), all of which were wild type in the 1st tumor; in addition, 6 other genes were also found to have distinct mutations between these other 2 tumors. This evidence concerns the gene NRAS and neoplasm.