Our patient’s metastatic calvarial lesions were positive for synaptophysin, chromogranin, cytokeratin AE1/3, and ACTH, without Crook cells-effectively an identical morphology to the primary sellar lesion. However, the impact non-CNS metastatic disease has on mortality in PC patient remains unclear due to the rarity of the pathology and heterogeneity of the disease manifestations. Here, POMC is linked to pachyonychia congenita.