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Quebec – Canada ( 3 , 4 , 5 ). The strong influence of highly prevalent founder SDHx mutations on the national epidemiology of PPGL is well typified by the experience of the Netherlands ( 6 ). In a large national survey ( n = 1045 DNA samples
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, which were developed from the Surveillance, Epidemiology, and End Results (SEER) database comprising more than 1000 ACC patients, have shown promising predictive accuracy in American patients ( 5 , 7 , 8 ). Recently, a scoring system known as the S
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