Tissue from the renal mass biopsy, however, was sent for genetic testing and that confirmed two TSC2 gene mutations (H1620R, Y1650C)...the patient was started on personalized off-label therapy with an mTOR inhibitor, everolimus, at a dose of 10 mg oral on a daily basis in the frontline setting....Repeat CT scans approximately every 3 mo have shown excellent response in most disease sites...