In our case, BIPSS was necessary to lateralize the site of ACTH production, because of the coexistence of an ACTH-secreting microadenoma and a pituitary “incidentaloma.” Transsphenoidal surgery led to a successful remission of the hypercortisolism, followed by a dramatic improvement in the patient's auxological parameters. Here, POMC is linked to adrenal gland hyperfunction.