Analyses performed by Mitsuko et al. in hereditary leiomyomatosis and renal cell cancer (HLRCC)-associated-renal cell carcinoma with FH deficiency supported the findings reported by Alaghehbandan et al. Most of the examined tumors demonstrated a high expression of PD-L1; however, 21% of specimens showed negative staining. The gene discussed is CD274; the disease is hereditary clear cell renal cell carcinoma.