Therefore, we also propose a hypothesis that the minority of sporadic ccRCCs akin to VHL disease can progress through cyst-dependent pathway from MCRN-LMP to ccRCC with cystic component similar to MCRN-LMP (Fig. 5), but the majority of sporadic ccRCCs are through cyst-independent pathway, and further research is needed to support our hypothesis. The gene discussed is PDLIM7; the disease is cyst.