CTNNB1 and adrenal cortex carcinoma: Oncogenic aberrations associated with ACC consist of the activation of the Wnt/β-catenin pathway.28 A study investigated whether Wnt pathway activation is involved in adrenocortical tumorigenesis in which 21 of 39 tumors (54%) had an alteration in β-catenin.18 This study suggested that the activation of the Wnt signaling pathway is the most common abnormality in adrenocortical tumorigenesis.18 In sporadic adrenocortical adenomas and ACC, the most common defect is due to genetic alterations in exon 3 of the somatic β-catenin gene (CTNNB1).36