PMS2 and neoplasm: It is also worth noting that it is often unclear if the germline and somatic variants are in cis or trans; however, the somatic and germline variants are presumed to be in trans when the data collectively indicates that this is the most likely situation (e.g., a somatic variant in PMS2 is identified in a patient with a germline PMS2 VUS and isolated loss of PMS2 in tumor nuclei).