RNA-seq analysis showed that tumors in our cohort exhibited upregulation of numerous genes known to be highly overexpressed in ACC (e.g. PRAME, ELAVL2, SOX11, HAPLN1, VTCN1, GABRP, TTYH1, TLX1, ART3, EN1, BEX1, POU3F2 and FABP7) [65–71] including drivers associated with ACC carcinogenesis such as MYB, KIT, AXL, SOX4, CCND1, CCNB1 and CDK1 (Fig. 1A, Supplementary Table 3) [69, 72–74]. Here, SOX4 is linked to adrenal cortex carcinoma.