Findings from whole-genome, whole-exome and/or transcriptome sequencing of 37 paediatric adrenocortical tumours have demonstrated the prognostic importance of specific mutations. 100% of tumours had IGF2 overexpression, and the majority (78%) had TP53 mutations. The presence of concomitant mutations was found to be predictive of clinical outcome; in particular, the presence of concomitant somatic ATRX and germline TP53 mutations was associated with significantly worse event-free survival and higher disease stage.