A different study landed further support to the involvement of the Wnt-β-catenin pathway, by showing accumulation of β-catenin in PPNAD tissues, as well as activating somatic CTNNB1 variants in macronodules, but not in micronodules or the contralateral adrenal gland (123). The gene discussed is CTNNB1; the disease is primary pigmented nodular adrenocortical disease.