Upon assessing frequencies of oncogenic pathway alterations, MYC pathway alterations were significantly enriched in the patients with LMD (p = 0.013, q = 0.14) and regional progression (both single: p = 0.023, q = 0.255, and multifocal: p = 0.023, q = 0.255) compared to local progression (Fig. 2E). This evidence concerns the gene MYC and Langer mesomelic dysplasia.