POMC and pachyonychia congenita: Few studies have specifically examined these patients; however, the propensity for a small population of neoplastic cells to generate extreme quantities of ACTH and therefore downstream corticosteroids may be an important index and an area for further investigation in the future-particularly when considering tumors that biochemically behave like true carcinomas even before the diagnosis of PC, as demonstrated by the lack of the expected response on high-dose dexamethasone suppression testing [18, 19].