As MNAC is an HPV-independent neoplasm, it follows a distinct pathophysiology and has been linked to several genetic mutations, including KRAS/NRAS, ARID1A, ARID1B, SMARCA4, and CTNNB1 mutations, along with chromosomal alterations such as gains of 1q, chromosomes 10 and 12, and loss of 1p [53,55,61]. Here, NRAS is linked to neoplasm.