Figure 5

Model depicting possible evolution of DICER1-affected kidney tumors. Dotted arrows represent rare events, solid lines represent more common events, arrows with dots and dashes represent events with unknown frequencies. Wilms tumor with biallelic DICER1 mutations is rarely observed,²⁰ but it seems likely that many anaplastic sarcomas of the kidney arise in pre-existing pediatric cystic nephromas.^{6, 7, 8}