In a recent European multicenter study of 169 patients with metastatic disease, 53% had a prior surgery for pheochromocytoma, elevated urine or plasma hormones were positive in 81%, a genetic SDHB variant was found in 42%, and the time from initial diagnosis to malignant disease was 43 months (0–614) [110]. This evidence concerns the gene SDHB and metastatic neoplasm.