In this study, we showed that ACC with atypical mitosis harbored TP53 somatic variants and is likely to be associated with AURKA-mediated M phase deregulation due to overexpression of CCNB2. When AURKA inhibitors can be used clinically in the future, ACC with atypical mitotic figures may be an active indication for AURKA inhibitor administration. The gene discussed is TP53; the disease is adrenal cortex carcinoma.