For this investigation, we focused on analyzing the frequency of the ARMC5 allelic variants in a multicenter cohort of patients with adrenal incidentalomas (bilateral and unilateral adrenal nodules) or with bilateral adrenal nodules associated with adrenal ACTH pituitary independent Cushing's syndrome. Here, POMC is linked to Cushing syndrome due to macronodular adrenal hyperplasia.