POMC and Cushing syndrome due to macronodular adrenal hyperplasia: In total 164 cases of Cushing’s syndrome were found of which 61.6 % owed to excess ACTH production from a pituitary tumor (Cushing’s disease), 32.3 % to an adrenocortical tumor/hyperplasia, and 6.1 % to ectopic ACTH syndrome (Table 1).