<i>BCORL1</i> S878G, <i>GNB1</i> G116S, <i>SH2B3</i> A536T, and <i>KMT2D</i> S3708R tetramutation co-contribute to a pediatric acute myeloid leukemia: Case report and literature review. The gene discussed is BCORL1; the disease is acute myeloid leukemia.