VHL and metastatic neoplasm: Without considering the 10 main somatic PPGL gene drivers represented in our cohort (HRAS, FGFR1, CSDE1, MAML3, IDH1, RET, VHL, NF1, MAX, and EPAS1), ATRX was found mutated in the tumors of 3.4% patients (Supplementary Table 2) and was established as the only gene significantly mutated in metastatic tumors (Fisher’s test, P = 2.9 × 10−4), as previously reported8.