Multivariable analysis revealed that acinar cell carcinoma (ACC) (Odds ratio [OR] 1.87, 95% confidence interval [CI] 1.00–2.67), KRAS wild type (KRASWT) (OR 3.09, 95% CI 2.49–3.85), and use of F1CDx (OR 2.38, 95% CI 1.98–2.85) were significantly associated with actionable gene aberrations. This evidence concerns the gene KRAS and adrenal cortex carcinoma.