Our predictive model can potentially aid in providing better surgical options for patients with uPA who could benefit from ipsilateral adrenalectomies and guide postoperative following strategy.PerspectivesCOMPETENCY IN MEDICAL KNOWLEDGE: Identification of uPA harboring KCNJ5 mutations requires adrenalectomy and sampling of the patient’s adrenal tumor tissues for Sanger sequencing, which is invasive and highly complex. The gene discussed is KCNJ5; the disease is adrenal gland neoplasm.