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We identified pathogenic germline variants in CSGs previously ( , , , mismatch repair genes), rarely ( , , , ), or never ( ) reported in RMS. Numerous genes ( , , mismatch repair) were on the ACMG Secondary Findings 2.0 list. In two cohorts of patients with RMS, we identified pathogenic germline variants for which gene-specific therapies and surveillance guidelines may be beneficial. In families with a proband with an RMS-risk P/LP variant, genetic counseling and cascade testing should be considered, especially for ACMG Secondary Findi