In addition, Ferrarotto et al. [40] found that upregulation of Notch signaling suppress myoepithelial differentiation in ACC, a characteristic of the solid subtype, so NOTCH1 mutation is likely to promote the formation of solid subtype and associated with increased rates of liver and bone metastasis and poor prognosis in PACC. Here, NOTCH1 is linked to adrenal cortex carcinoma.