The precise detection of the etiology avoids unnecessary interventions after thelaboratory has confirmed that the disease is endogenous Cushing’s Syndrome.Cushing’s disease is the major etiology of Cushing’s Syndrome for patients over fiveyears of age, while ectopic ACTH secretion is extremely rare in children andadolescents.6 This evidence concerns the gene POMC and Cushing syndrome due to macronodular adrenal hyperplasia.