In ACCs, Path/LP variants were found in TP53, CTNNB1, ATRX, MLH1, ATM, CDKN2A/CDKN2B, KMT2A, and MSH6 in 3 or more patients (Fig. 2A), but only 63% of patients with ACC had at least one of these mutations and 10 participants had Path/LP variants in genes found in fewer than 3 patients, demonstrating the molecular heterogeneity of this ACC cohort. This evidence concerns the gene MSH6 and adrenal cortex carcinoma.