This study identified several significant mutant genes in ACC tissues, including TP53, CTNNB1, MEN1, PRKAR1A, and RPL22. Increased copy numbers of TERT gene (5p15.33), TERF2 gene (16q22.1), CDK4 gene (12q14.1), and CCNE1 gene (19q12), as well as deletions of RB1 gene (13q14.2), CDKN2A gene (9p21.2), and ZNRF3 gene (22q12.1), were also detected in ACC tissues. Here, RB1 is linked to adrenal cortex carcinoma.