Although we find early mutations, including those of driver genes (ATRX, TP53, LZTR1 and TGFBR2), present in branches shared by more than one tumor region, the results of this analysis demonstrate a high degree of intra-tumoral heterogeneity in the three patients, with private leaf node mutations dominating the mutational landscape. The gene discussed is LZTR1; the disease is neoplasm.