Supporting these observations, gene set enrichment analysis (GSEA) revealed that the top upregulated pathways in ACC were represented by processes that promote tumor growth, metastasis, and chemoresistance such as oxidative phosphorylation, DNA replication, cell cycle progression, glycolysis, DNA repair, MYC, WNT, NOTCH, mTORC1, Hedgehog, and PI3K-AKT signaling (Fig. 1B, Supplementary Table 4). The gene discussed is PIK3CA; the disease is adrenal cortex carcinoma.