In the primary/lymph node metastases-paired group, 15 gain-of-function mutations were observed, two of them being pathogenic (1 in APC and 1 in TP53); 6 mutations were VUS of potentially pathogenic genes, such as ALK, ATM, BRAF, PIK3CA. Here, PIK3CA is linked to metastatic malignant neoplasm in the lymph nodes.