Primary bilateral macronodular adrenal hyperplasia (PBMAH), also known as adrenocorticotropic hormone (ACTH)-independent macronodular adrenal hyperplasia (AIMAH), is a rare cause of Cushing’s syndrome [1, 2], characterized by increased cortisol production from bilateral adrenal macronodules. The gene discussed is POMC; the disease is Cushing syndrome.