[9,10] Further, up to 10% of myelolipoma patients have been reported to have CAH.[11] The possible mechanism underlying this association is based on the exposure to a chronically excessive level of ACTH leading to the development of adrenal myelolipoma.[3,9,10] This is supported by the fact that many myelolipoma patients with CAH are untreated or have poorly controlled CAH. The gene discussed is POMC; the disease is congenital adrenal hyperplasia.