A whole exome sequencing analysis using genomic DNA extracted from peripheral leukocytes and paraffin-embedded tumor tissue revealed no germline or somatic gene alterations (22), such as in PRKACA, CTNNB1, GNAS, ARMC5, PRKAR1A, PDE11A, or PDE8B, which have been reported in adrenal cortisol-producing adenomas (31). This evidence concerns the gene ARMC5 and neoplasm.