VHL and nonpapillary renal cell carcinoma: This study provides a basis for early surgical intervention of solitary thyroid metastases (the median survival period is 21 months longer than untreated patients), but it should be noted that ThyroSeq does not cover VHL promoter methylation (~7% of ccRCC inactivation mechanisms) and some rare driver genes (such as PBRM1/SETD2) (21).