Furthermore, of the differentially methylated genes in primary ACC, compared with benign tissue samples, several CpG sites were differentially methylated including those associated with KCTD12, KRREL, SYNGR1, and NTNG2 and those in chromosome 11p15 imprinted region including IGF2 and H19. Other sites were also in the IGF2 pathway, including IGF1R that IGF2 binds to and AKT1, a downstream signaling molecule in the cell survival pathway of IGF1R. TP53 and CTNBB1 both had hypomethylated sites, RARRES2 and SC16A9 had several hypermethylated sites in ACC tissue samples. Here, SYNGR1 is linked to adrenal cortex carcinoma.