The Wnt-signaling (CTNNB1, ZNRF3) and p53-Rb (TP53, Rb, CDKN2A, RPL22) pathways were already known to play a role in ACC development, with the activation of the Wnt-signaling pathway thought to be one of the initial events in tumor development [23]. Here, RB1 is linked to adrenal cortex carcinoma.