IGF1R and adrenal cortex carcinoma: Genetic alterations identified so far in ACC span key pathways, among which are Wnt/β-catenin signaling (16, 17), insulin-like growth factor 2/insulin-like growth factor 1 receptor (IGF2/IGF1R) pathway (18–21), cell cycle and p53-mediated apoptosis (16, 22), telomere maintenance (23, 24), cAMP-PKA signaling (25, 26), covering multiple steps involved in transcription and translation.