TR58 (stage IIA, adenocarcinoma, 70-year-old male with multiple sclerosis and diabetes mellitus, smoker) has a STAT5B frame-shift mutation c.1102del characterized as pathogenic with high impact on protein function and associated with immune dysregulation, including chronic pulmonary disease, interstitial pneumonitis, recurrent or severe infections, eczema, and autoimmune arthritis; and a BRCA1 splice-site mutation c.5075-1G>C characterized as pathogenic with high impact on disease development and reported in hereditary breast and ovarian cancer syndrome, and breast-ovarian familial cancer. The gene discussed is BRCA1; the disease is multiple sclerosis.