POMC and adrenal gland hyperfunction: Biochemical testing indicated ACTH-independent hypercortisolism: multiple ACTH measurements <5 pg/mL (<1.1 pmol/L), unsuppressed cortisol after 1-mg DST, mean 24-hour UFC 19.8 μg/d (54.6 nmol/d) [normal <50 μg/d (<138 nmol/d)], mean LNSC 2.1 ng/mL (5.79 nmol/L) [normal range 1.0 to 1.5 ng/mL (2.76 to 4.14 nmol/L)], and low dehydroepiandrosterone sulfate (DHEA-S) (Table 2).