More recently, in a large European study on stage IV ACC, the tumor grading, as the association of the Ki67 and the Weiss score, has been considered as an important prognostic parameter of overall survival (Libé et al., 2014), confirming the data on the mitotic count showed in a previous French series (Assie et al., 2007). The gene discussed is MKI67; the disease is adrenal cortex carcinoma.