Ferrarotto R et al. genotyped 102 ACCs that have available pathologic and clinical data, showing that NOTCH1 mutations define a distinctive aggressive ACC subgroup associated with a significantly higher likelihood of solid subtype, advanced-stage disease at diagnosis, higher rate of liver and bone metastases, shorter disease-free survival and shorter overall survival when compared with NOTCH1 wild-type tumors [59]. The gene discussed is NOTCH1; the disease is adrenal cortex carcinoma.