POMC and Cushing syndrome due to macronodular adrenal hyperplasia: Pathophysiological chronic exposure to excessive concentrations of ACTH results in elevated glucocorticoid levels, as known for Cushing’s syndrome, with symptoms like visceral obesity, growth retardation, hirsutism, acne and hypertension (Bista and Beck, 2014; Lacroix et al., 2015), but no evidence for increased BAT activity.