For the validation cohort, we studied 171 patients, including 3 with PALs and 168 with other adrenal masses (42 nonfunctional adenomas, 57 PCCs, 4 adrenocortical carcinomas, 15 adrenal metastases, 1 case of ATB, 8 cases of hyperplasia, 1 angioleiomyolipoma, 4 cysts, 21 myelolipomas, 2 neuroblastomas, 1 ganglioneuroblastoma, 2 sarcomas, 1 schwannoma, 3 lymphogiomas, 3 ganglioneuromas, 1 teratoma, 1 eosinophil tumor, and 1 INI-1 deletion myoepithelial carcinoma). The gene discussed is SMARCB1; the disease is malignant myoepithelioma.