POMC and Cushing syndrome due to macronodular adrenal hyperplasia: 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).