Interestingly, a single sample from the TCGA ACC primary tumors (TCGA-OR-A5K4-01) also possessed LoF mutations in MSH6 and ATM (although both were nonsense mutations, Supplementary Fig. 5), and had the eighth-highest mutation rate of that sample of 92 primary tumors (24), suggesting compound LoF in these two genes may be driving hypermutation. This evidence concerns the gene MSH6 and adrenal cortex carcinoma.