CDK4 and adrenal cortex carcinoma: In addition, IGF2 (insulin-like growth factor 2), PRKAR1A, RPL22 (ribosomal protein L22), CCNE1 (cyclin E1), CDK4 (cyclin dependent kinase 4), TERT (telomerase reverse transcriptase), and TERF2 (telomeric repeat binding factor 2) have also been reported as genetic mutations in ACC [20].