Applying exome-seq, three studies discovered many somatic mutations in ACC of salivary gland and breast cancer.13, –15 Mutations were identified in known oncogenes such as PIK3CA, ATM, CDKN2A, SF3B1, BRAF and chromatin regulators including KDM6A, SMARCA2, and SMARCA5. Prominently, Notch and FGF-IGF-PI3K signaling pathways were highlighted in the exome-seq findings. Here, PIK3CA is linked to adrenal cortex carcinoma.