Overgrowth syndromes such as Perlman syndrome and associated pediatric cancers, including Wilms tumor, arise through genetic and, in certain instances, also epigenetic changes. In the case of the Beckwith-Wiedemann overgrowth syndrome and in Wilms tumor, increased levels of have been shown to be causally related to the disease manifestation. In the previous issue of, Hunter and colleagues (pp. 903-908) investigated the molecular mechanisms by which mutations in the gene encoding the RNA degradation component DIS3L2 lead to Perlman syndrome. By analyzing nephron progenitor cells derived from their newly created mutant mouse lines, the investigators showed that DIS3L2 loss of function leads to up-regulation of independently of the let7 microRNA pathway. In a second study in this issue of , Chen and colleagues (pp. 996-1007) show that microRNA processing gene mutations in Wilms tumor lead to an increase in the levels of transcription factor pleomorphic adenoma gene 1 (PLAG1) that in turn activates expression. Thus, augmented expression seems to be a common downstream factor in both tissue overgrowth and Wilms tumor through several alternative mechanisms.