Sequencing of the G3 liver metastasis demonstrated mutations in ATRX and MEN1 and deep deletions in CDKN2A/2B, TP53, and RB1. Sequencing of a G2 periaortic lymph node metastasis from 11 years prior to high-grade progression demonstrated identical variants in ATRX and MEN1, but no alterations in TP53 or RB1. Neither sample was hypermutated. Here, MEN1 is linked to metastasis.