Germline activating variants in WWP1, which encodes an E3 ubiquitin ligase that antagonizes PTEN tumor suppressive function, have been proposed as an alternative mechanism of PTEN inactivation in PTEN-hamartoma-tumor syndrome (PHTS) -like patients with wildtype PTEN. More specifically, heterozygous, potentially activating WWP1 variants were first identified by Lee et al in patients affected with gastrointestinal oligopolyposis, including adenomatous, hyperplastic/serrated, and hamartomatous polyps, and occasionally with colorectal cancer. Subsequently, based on the PHTS phenotypic features, WWP1 mutational screening was performed in patients with thyroid nodules, or normocephalic autism spectrum disorder (ASD), where germline WWP1 variants were also identified.