At the time of detection of the source of ACTH hypersecretion, four patients had metastatic lesions: in regional lymph nodes associated with 1 small-cell lung cancer, in 1 patient they were due to the extension of thymic AC onto the phrenic nerve, and in another case resulted from large-cell thymus NET spreading to the left brachiocephalic vein. Here, POMC is linked to small cell lung carcinoma.