TERT and acral lentiginous melanoma: In comparison, RCC and UC tumors commonly harbor missense mutations in TP53 (5 out of 10) and SNVs at two hotspots in TERT promoter at nucleotide positions − 124 and − 146 upstream of ATG upregulating telomerase mRNA expression (6 out of 10) (Fig. 7), which occurred much less frequently in acral melanoma subjects in this study (0 out 7 for P53 mutation and 1 out of 7 for TERT promoter hotspots).