Multi-focal renal cell carcinoma tumors in a patient with VHL disease. Coronal sections from computed tomography scans show the spatial orientation of the tumors within the kidneys. (A) A macroscopically single tumor in the right kidney, but defined by exome sequencing as two tumors (one and two). (B) Two separate tumors in the left kidney, tumors three and four. Cysts typical of VHL disease are also present in both kidneys.