Kittah et al. (10) have reported that of 75 patients (98.7%) with synchronous PHEOs (41 MEN2, 13 VHL, 7 NF1, and 14 other PHEOs; the median tumor size of 3.0 cm), 74 underwent a synchronous bilateral adrenalectomy and synchronous bilateral CSA was successfully performed in 18 (24%) of them. Here, VHL is linked to neoplasm.