Within T-DNA, somatic variants were identified in 53% of ACA patients with a frequency distribution in line with previous studies (i.e., PRKACA in 30% of CPA-CS, CTNNB1 in 50% of CPA-MACS and 15% of CPA-CS, KCNJ5 in 50% of APA and CACNA1D in 9% of APA) [9–13, 27–29]. Here, PRKACA is linked to Cowden syndrome 1.