Assie and colleagues performed exome sequencing and single nucleotide polymorphism (SNP) analysis of 77 ACC tissues and showed alterations in the β-catenin pathway associated genes zinc and ring finger 3 (ZNRF3) (21%), cadherin-associated protein β1 (CTNNB1) (16%) and APC (2%) [51]. This evidence concerns the gene ZNRF3 and adrenal cortex carcinoma.