Other less common etiologies of endogenous Cushing’s syndrome include ectopic ACTH secretion (EAS ~10%), adrenal adenomas and carcinomas and, more rarely, adrenal primary macronodular adrenal hyperplasia (PMAH) or primary pigmented nodular adrenal disease (PPNAD) (Table 1). This evidence concerns the gene POMC and adrenal cortex adenoma.