Multiple growth factors and cytokines, including transforming growth factor-α (TGF-α) (35), transforming growth factor-beta 1 (TGF-β1) (35), vascular endothelial growth factor (VEGF) (35, 36), fibroblast growth factor (FGF-2) (9, 35), and several interleukins (35), play essential roles in ACC progression. This evidence concerns the gene TGFB1 and adrenal cortex carcinoma.