Although the neurohypophysis is associated with the storage and release of antidiuretic hormone, and is believed to be the origin of pituicytomas, only 5% of all reported cases presented with central diabetes insipidus (DI), for reasons that are unclear.10 In our case, the patient also denied any symptoms of DI; her primary clinical presentation was Cushing syndrome. Here, AVP is linked to Cushing syndrome due to macronodular adrenal hyperplasia.