Select somatic genetic alterations have been identified in several subtypes of adenomas, including high mobility group A 2 (HMGA2) amplification via focal amplification or abnormalities of chromosome 12 in prolactinomas (12), Ubiquitin Specific Peptidase 8 (USP8), Ubiquitin Specific Peptidase 48 (USP48), and BRAF in corticotroph adenomas (13, 15, 29), and activating mutations in GNAS in GH-secreting pituitary adenomas (14, 16). The gene discussed is USP48; the disease is ACTH-producing pituitary gland adenoma.