IHH and Cowden syndrome 1: There are any number of molecular abnormalities and associated targets that have been discovered in CS including isocitrate dehydrogenase (IDH) mutations, upregulation of Indian Hedgehog (IHH) signaling, tyrosine kinase receptor activity, misexpression of microRNAs, overexpression of growth factors and anti-apoptotic proteins, and mutations in tumor suppressor genes [28,29,30].