If VHL pathogenic mutations (e.g., missense/nonsense/frameshifting mutations) or copy number loss (CNA) were found together with loss of expression of thyroid epithelial markers (e.g., thyroglobulin), then it can specifically be diagnosed as metastatic ccRCC (all 18 cases were confirmed clinically). Here, TG is linked to nonpapillary renal cell carcinoma.