POMC and pituitary tumor: CD may be caused by hypersecretion of ACTH by the pituitary or one of the adrenals; if the latter is the focus of secretion, then the contralateral adrenal will atrophy.22 The finding of hyperplasia of both adrenals in our case implicated the pituitary tumor as the origin of hypersecretion, which is consistent with the finding that the adrenals had almost returned to their normal size 3 months following pituitary resection.